Evaluation of mucosal status in the follow-up of pediatric patients with celiac disease: the role of serology

Şengül, Özlem Kalaycik; Akkelle, Bilge Şahin; Ay, Pınar; Volkan, Burcu; Tutar, Engin; Çelikel, Çiğdem; Ertem, Deniz

doi:10.1007/s00431-022-04535-3

Cited by 2 publications

(3 citation statements)

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“…Specificity of tTG-IgA is higher: 80 % for adults and 90 % for children, indicating that a positive tTG-IgA can be considered as a reliable marker of disease activity. In contrast, a prospective pediatric study [8] showed that tTG-IgA had a high negative predictive value for mucosal recovery (92 %) but a very low positive predictive value (43 %), illustrating that the data until now are equivocal.…”

Section: Introductionmentioning

confidence: 91%

“…In daily practice these diagnostic cut-offs are used both for diagnosis and for monitoring, but it is not evident that these cut-offs are optimal for monitoring CD patients on a GFD. This concern is supported by a recent pediatric CD study [8] showing that the cut-off value for tTG-IgA as marker of mucosal recovery was higher than the value for diagnosis.…”

Section: Introductionmentioning

confidence: 91%

“…The mean i-FABP result of all diagnostic samples was 1732 ± 1843 ng/L (range<44. [6][7][8]470). No correlation was found between the i-FABP results and the levels of tTG-IgA of either method.…”

Section: I-fabpmentioning

confidence: 99%

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Monitoring patients with celiac disease on gluten free diet: different outcomes comparing three tissue transglutaminase IgA assays

Mulder,

Castelijn,

van der Pol

et al. 2023

Clinical Chemistry and Laboratory Medicine (CCLM)

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Objectives Tissue transglutaminase (tTG) IgA antibodies are a hallmark for celiac disease (CD). In CD patients on gluten free diet (GFD) these antibodies are transient. Few studies are available comparing the tTG-IgA assay characteristics for monitoring response to GFD. Since discrepant results were reported in patients on GFD after switching tTG-IgA assays, we conducted a retrospective observational study to monitor GFD response using three different tTG-IgA assays. Methods Diagnostic samples from 44 adults and 17 children with CD were included. Of most patients two follow-up samples after introduction of GFD were available. In all samples tTG-IgA were assessed using one fluorochrome-enzyme immuno-assay (FEIA) and two chemiluminescence immuno-assays (CLIA) and intestinal fatty acid binding protein (i-FABP) as surrogate marker for intestinal epithelial damage was measured. Results Using CLIA assays, normalization of antibody levels was delayed compared to FEIA (p<0.001). Of all samples taken after at least 6 months on GFD with elevated i-FABP indicating intestinal epithelial damage, 40 % had positive tTG-IgA according to the FEIA, 85 and 90 % according to the two CLIA. Conclusions Normalization of tTG-IgA in patients on GFD depends on the assay used. Both CLIA appear to be more sensitive in detecting suboptimal treatment response in CD-indicated by elevated i-FABP – when applying the manufacturer’s recommended cut-off for the diagnosis of CD.

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Section: Introductionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 91%