Comparison of Tissue Transglutaminase and Anti-Endomysial Antibody Tests in Diagnosis of Celiac Disease

Abstract

Background: Although initially considered as a digestive tract disease, celiac disease (CD) can cause problems and complications in most other organs. Common serologic tests for the diagnosis of CD include anti-tissue transglutaminase (tTG) and anti-endomysial Ab (EMA). A more recent test includes anti-deamidated gliadin peptide. Objectives: This study aimed to compare the values of tissue transglutaminase and endomysial antibodies in A and G Immunoglobin subtypes in patients with a definitive diagnosis of CD. Methods: Patients suspected of CD referring to a Gastrointestinal Pediatric Clinic were evaluated for CD using IgG and IgA for tissue transglutaminase and endomysial antibodies and total IgA. Endoscopy and biopsy were done based on the CD diagnosis protocol. The demographic data of children were recorded in a questionnaire and then analyzed. Results: Of the 54 patients diagnosed with CD, 29 were females and 25 were males. TTG-IgA had the highest positivity rate. Tests based on IgA were more positive than IgG tests. More than one test was positive in 81.5% of the patients. All four tests were positive in 16 patients. In 18.5 percent of patients, just one test was positive. In the latter group, TTG-IgA was positive in four patients. The coefficient of agreement between EMA-IgA and TTG-IgA was 0.435, which was statistically significant. Conclusions: We suggest tissue transglutaminase and endomysial antibodies in A and G Immunoglobin subtypes for the diagnosis of CD. In this method, the diagnostic sensitivity of CD is high and in the next step, endoscopy and sampling can increase the specificity value. If the tests are not available, preferable tests are IgA subtype antibodies.