Antitissue transglutaminase antibody determination versus upper endoscopic biopsy diagnosis of paediatric celiac disease

作者：Saginur Michael; AlRefaee Fawaz A M; Spady Donald W; Girgis Safwat A M; Huynh Hien Q; Prosser Connie I; Persad Rabin; Turner Justine M^*

来源：Paediatrics and Child Health, 2013, 18(5): 246-250.

• Antitissue transglutaminase antibody
• Celiac disease
• Diagnosis
• Paediatrics
• Serology
• Upper endoscopy

BACKGROUND: European guidelines question the requirement for intestinal biopsies to diagnose celiac disease in children.
OBJECTIVE: To determine the specificity of serological diagnosis of celiac disease (CD) using antitissue transglutaminase antibody (aTTG) levels in a general pediatric referral population.
METHODS: Children referred from 2005 to 2008 with a positive aTTG test were included, regardless of symptoms. Diagnostic endoscopy was performed and a minimum of six biopsies were obtained. Histological samples were reviewed in a blinded manner, and specificities and sensitivities of aTTG threshold levels for a diagnostic Marsh score >= 3 were determined.
RESULTS: A total of 115 eligible patients were identified, 73% of whom had a Marsh score >= 3. The specificity of an aTTG level of >= 100 U/mL was 97% (95% CI 93.5% to 100%); an aTTG level >= 200 U/mL was 100% (95% CI 89% to 100%) specific.
CONCLUSION: Further research is required before considering a change in diagnostic standards in Canada. In this region, the threshold aTTG level to provide diagnostic specificity of 100% is significantly greater than the threshold aTTG level being proposed for diagnosis in Europe.

• 出版日期2013-5