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Is tissue transglutaminase autoantibody the best for diagnosing celiac disease in children of developing countries?
Ujjal Poddar1, Babu Ram Thapa, Chander Kanwal Nain
1Division of Pediatric Gastroenterology, Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. ujjal@sgpgi.ac.in
Insights
Tissue transglutaminase (tTG) antibody is a highly sensitive and specific marker for detecting celiac disease in Indian children. Its ease of use makes it a valuable alternative to anti-endomysial antibody (EMA) in developing nations.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Clinical Diagnostics
Background:
- Celiac disease (CD) diagnosis in children often relies on serological markers.
- Tissue transglutaminase (tTG) antibody is a key biomarker for CD.
- Evaluating diagnostic accuracy in specific pediatric populations is crucial.
Purpose of the Study:
- To assess the diagnostic utility of tissue transglutaminase (tTG) antibody for celiac disease in Indian children.
- To determine the sensitivity, specificity, and predictive values of tTG antibody in this demographic.
- To compare tTG antibody with anti-endomysial antibody (EMA) in the Indian pediatric population.
Main Methods:
- Prospective evaluation of 333 children under 14 years with suspected CD over 3 years.
- CD diagnosis based on modified ESPGHAN criteria.
- Detection of tTG antibody using a commercial ELISA kit; EMA and IgA-antigliadin antibody used for comparison in a subset.
Main Results:
- 180 children diagnosed with CD, presenting with diarrhea (84%) and failure to thrive (87%).
- tTG antibody demonstrated high sensitivity (94%) and specificity (97%) at a cutoff of 10 U/mL.
- High concordance between tTG antibody and EMA (95% in cases, 97.5% in controls).
Conclusions:
- tTG antibody is a highly sensitive and specific serological marker for celiac disease in Indian children.
- Its technical simplicity and high concordance with EMA support its use as an alternative diagnostic tool.
- Facilitates celiac disease diagnosis in resource-limited settings like India.
Aim:
To prospectively evaluate the role of tissue transglutaminase (tTG) antibody in detecting celiac disease (CD) in Indian children.
Methods:
Over a period of 3 years, 333 children (
Results:
The mean age of 180 children with CD was 6.5+/-3 years with a male to female ratio of 1.7:1. Their presenting complaints were diarrhea in 84% and failure to thrive in 87%. Wasting, stunting, and anemia were seen in 87%, 59%, and 83% of cases, respectively. The best sensitivity and specificity of tTG antibody we have got at a cut-off value of 10 U/mL and were 94% and 97%, respectively, with a positive predictive value of 98% and negative predictive value of 92.4%. The mean tTG antibody titer was 106+/-76 U/mL in cases and 2+/-1.6 U/mL in controls (P<0.001). The concordance of tTG antibody with EMA was 95% in cases and 97.5% in controls.
Conclusions:
tTG antibody is a highly sensitive and specific serologic marker. Being technically simpler and due to its high concordance with EMA, it can be used as an alternative to EMA in developing countries like India.
