Suboptimal performance of IgG anti-tissue transglutaminase in the diagnosis of celiac disease in a tropical country

Dig Dis Sci. 2010 Mar;55(3):698-702. doi: 10.1007/s10620-009-0789-1. Epub 2009 Mar 31.

Abstract

Serological tests using human IgA-anti-tTG have been reported to have high sensitivity and specificity in diagnosis of celiac disease. There is a paucity of data on the use of human IgG-anti-tTG in diagnosis of celiac disease. Ninety-two patients with clinical suspicion of celiac disease who underwent duodenal mucosal biopsy and celiac serology using human IgG-anti-tTG were included in this retrospective study. Diagnostic accuracy of human recombinant IgG-anti-tTG serological test for celiac disease was evaluated. Indications for celiac serological testing were diarrhea (92.3%), hypoalbuminemia (39.1%), and anemia (35.9%). Eighteen patients were diagnosed with having celiac disease and 14 (77.8%) of them were IgG-anti-tTG positive. Of the remaining 74 patients, eight (10.8%) were false-positive for IgG-anti-tTG. Sensitivity, specificity, PPV, NPV, and diagnostic accuracy of IgG-anti-tTG in celiac disease were 77.8, 89.1, 63.6, 94.2, and 87%, respectively. Human IgG-anti-tTG alone does not perform well as a diagnostic tool for celiac disease. The utility of anti-endomysial antibodies in a similar clinical setting needs to be evaluated.

MeSH terms

  • Adult
  • Antibodies / blood*
  • Celiac Disease / diagnosis*
  • False Positive Reactions
  • Female
  • Humans
  • Immunoglobulin G / blood*
  • Male
  • Retrospective Studies
  • Sensitivity and Specificity
  • Transglutaminases / immunology*
  • Tropical Climate

Substances

  • Antibodies
  • Immunoglobulin G
  • Transglutaminases