Utilidad De Los Anticuerpos Antitransglutaminasa Tisular Y Su Relación Con Enfermedad Celíaca en Pacientes Del Hospital San Juan De Dios De Enero Del 2008 a Diciembre Del 2010

Abstract

Conclusiones: en cuanto a las variables epidemiológicas la EC se comporta de manera similar a lo descrito. No se encontró asociación con patologías clásicamente asociadas con la enfermedad. La validez de las pruebas anti-tTG en la población estudiada es mucho menor a la encontrada en la literatura. PALABRAS CLAVEAnticuerpos antitransglutaminasa tisular. Enfermedad celíaca. Clasificación de Marsh. ABSTRACTBackground: Celiac disease (CD) is a small intestine enteropathy that is caused by the ingestion of gluten protein in food. The main determinant found is the enzyme tissue transglutaminase, an enzyme of the small intestine. This study pretends to assess the validity of anti-tTG in patients admitted to HSJD with the diagnosis of CD, because the clinic experience suggests a fewer sensitivity as the report in literature. Methods:The population studied was patients twelve years or older with positive serology for anti-tTG and excluded patients receiving steroids or immunosuppressive therapy, patients with gastrointestinal surgery, HIV/AIDS or being on a gluten-free diet. We consider patients as having CD those with symptoms, classic pathological changes and/or a response to free-gluten diet. Age, ethnicity, gender and frequency of chronic diseases were documented; and also sensitivity, specificity, PPV and NPV for anti-tTG was measured. A distribution according Marsh histological classification was made. The presence of IgA deficiency was evaluated. Findings:We found CD was more frequent in women and older patients. The sensitivity and specificity found for anti-tTG IgA was 17% and 96%, whereas anti-tTG IgG was 14.2% and 100% respectively. The PPV and NPV were 75% and 100% in the case of IgA and 65% and 62.5% for IgG. Most of the histologic specimens were Marsh 3 or superior. IgA deficiency was not found. Interpretation:The epidemiologic features in CD were similar to those describe in literature. It was not found classic associated disorders to CD. The validity of anti-tTG for diagnosis of CD was lower as described.