engleski

The Role of Recombinant Human Tissue Transglutaminase as a Predictor of Childhood Coeliac Disease

This study was aimed at determining the role of recombinant human tissue transglutaminase (tTG) as a predictor of coeliakia in children with nonspecific gastrointestinal symptoms. tTG has been identified as the major autoantigen in coeliakia, increasing in untreated disease. The study comparised a total of 64 children, average age 3, 8 years (median 3, 5 years, range 1 -10 years), presenting with diarrhoea, malabsorption, short stature, weight loss, etc. To set indication for biopsy, serum levels of tTg and endomysium IgA antibodies (EMA-IgA) were estimated in all children. IgA-tTG antibodies were determined with an enzyme linked immunosorbent assay (ELISA). ROC-analysis determined the optimal cut-off to be at 7.7 arbitrary units per milliliter. IgA-EMA were analyzed by indirect immunofluorescence, using monkey oesophagus as a substrate. The results revealed the values of tTG and EMA-IgA antibodies to be increased in 25 out of 64 children, out of which coeliakia was proven by small intestine biopsy in 24. Statistics revealed the sensitivity of the tTG test to be 92% and its specificity to be 93%. Positive predictive value was established at 88% and the negative one at 95%. In comparison, sensitivity of the EMA-IgA test was revealed to be 88%, its specificity 90%, positive prediction 84% and negative prediction 92%. Even though EMA-IgA test proved to be satisfactory useful, tTg test enables more sensitive and more accurate early detection of coeliakia and should therefore be preferred.

tissue transglutaminase; coeliac disease; children

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