Evaluation of tissue transglutaminase IgA antibody in diagnosis and following up of celiac disease in children

Aim: It is studied to challenge a costeffective, easy applicable, diagnostic algorithm that has high spesivity an sensitivity in pediatric patients with celiac disease.In our study we aimed to determine the relationship between a quick and easy finger tip celiac disease test and the other tests in addition to effective of diet monitorization.
Patients and Method: 33 (64.7%) of the cases was girl and 18 (35.3%) was boy and the patients were 1-17 (6.59±4.51) years old. All of the patients were diagnosed as celiac disease by upper gastrointestinal endoscopy. There is no patient detected with selective IgA deficiency. 36% of patients were adapted to diet and 15% was not. Tissue transglutaminase (tTG) IgA was performed by immuno-cromatographic method called Biocard Celiac test (AniBiotech, Vantaa, Finland). Statistical analysis were done with NCSS 2007 programme.
Results: tTG IgA test was positive in 24 and negative in 27 patients. tTG IgA, antigliadin antibody (AGA IgG) and antiendomisium antibody (EMA IgA) were consistent as diagnosing methods. tTG IgA test was 100% positive in diet non adapted group where as 75% was negative in diet adapted group (p=0.002). There is no statistical difference in terms of AGA IgA, AGA IgG and EMA IgA in diet adapted or non adapted gruops (p=0.119, p=0.083, p=0.419). There is no difference between AGA IgA and AGA IgG (p=0.241). There is statistical difference between AGA IgA and EMA IgA (p=0.001) and no statistical difference was detected between AGA IgA and IgG (p=0.098).
Discussion: Cromatographic detection of tissue transglutaminase which is an easy applicable and cheap test is consistent with EMA IgA test which is spesific and sensitive at diagnosing. tTG IgA test is sensitive in diet adapted group however could be assessed as false positive in diet adapted group. In this case patients should be reassesed with their clinical and laboratuary findings.

Çocuklarda çölyak hastalýðýnýn taný ve takibinde doku transglutaminaz-IgA antikorunun yeri

Amaç: Pediatrik çölyak hastalarýnda yüksek duyarlýlýk ve özgüllüðe sahip, maliyeti daha düþük, uygulanýmý kolay bir taný algoritmasý geliþtirilmeye çalýþýlmaktadýr. Çalýþmamýzda hýzlý ve pratik olarak parmak ucundan uygulanan çölyak hastalýðý testinin diðer testler ile iliþkisi ve diyet monitorizasyonundaki etkinliðinin saptanmasýný amaçladýk.
Hastalar ve Yöntem: Olgularýn 33 (%64.7)’ü kýz, 18 (%35.3)’i erkekti ve yaþlarý 1-17 (6.59±4.51) yýl arasýndaydý. Tüm olgular üst gastrointestinal sistem endoskopisi ile çölyak hastalýðý tanýsý almýþlardý. Selektif IgA eksikliði hiçbir olguda yoktu. Hastalarýn 36 (%70.6)’sý diyete uyumluyken, 15 (%29.4)’i diyete uyumsuzdu. Doku transglutaminaz (tTG) IgA antikoru, “Biocard Celiac Test” (AniBiotech, Vantaa, Finland) ile immunokromatografik yöntemlebelirlendi. Ýstatistiksel analizler NCSS 2007 programý ile yapýldý.
Bulgular: tTG IgA testi 24 hastada pozitif, 27 hastada negatifti. Taný koymada tTG IgA antikor pozitifliði ile antigliadin (AGA) IgG ve antiendomisyum (EMA) IgA antikor düzeyleri arasýnda uyum olduðu saptandý. Diyete uymayan grubun %100’ünde tTG IgA testi pozitif iken diyete uyan grubun %75 (n=27)’inde test negatif bulundu (p=0.002). Diyete uyan ve uymayan olgular arasýnda AGA IgA, AGA IgG ve EMA IgA antikor düzeyleri açýsýndan anlamlý fark gözlenmedi (p=0.119, p=0.083, p=0.419). AGA IgA ile AGA IgG düzeyleri arasýnda anlamlý fark yoktu (p=0.241). AGA IgA ile EMA IgA arasýnda istatistiksel anlamlý iliþki gözlendi (p=0.001). AGA IgG ile EMA IgA arasýnda anlamlý
iliþki yoktu (p=0.098).
Sonuç: Kolay uygulanan ve ucuz bir test olan doku transglutaminaz IgA antikorunun kromatografik tespiti, çölyak hastalýðý tanýsý koymada duyarlý ve spesifik bir test olan EMA IgA ile uyumluluk göstermektedir. tTG IgA testi, diyete uymayan olgularý iyi tespit ederken, diyete uyan olgularda yanlýþ pozitiflik verebilmektedir. Bu durumda hastalar klinik ve laboratuvar bulgularýyla tekrar deðerlendirilmelidir.