Diagnostic Accuracy of Anti-Tissue Transglutaminase Antibodies (IgA) in Patients with Suspicion of Celiac Disease by Keeping Histopathology as Gold Standard

Background: Celiac disease occurs in children with chronic diarrhea, weight loss, gastrointestinal symptoms, development of gastrointestinal cancer, vomiting, constipation, dental enamel defects, osteoporosis, dermatitis herpetiformis, short stature, persistent iron deficiency anaemia and delayed puberty and in asymptomatic individuals with type 1 diabetes, and first degree relatives of individuals with celiac disease. Aim: To determine the diagnostic accuracy of anti-tissue transglutaminase antibodies (IgA) in patients with suspicion of celiac disease by keeping histopathology as gold standard Design: It was a cross-sectional study. Study settings: The study was conducted at indoor and outdoor patients at Pakistan Atomic Energy Commission General Hospital Islamabad for a period of 03-09-2017 to 02-03-2018. Methods: Total 146 of both the genders were enrolled in this study. TTG (IgA) antibodies were done by ELISA method. Report was finalized by pathologist. Biopsy was performed at PAEC General Hospital Islamabad by gastroenterologist. Biopsy specimen was send to AFIP. The report was verified by histopathologist of same hospital. Statistical analysis was preformed to compute sensitivity, specificity, positive and negative predictive values by making 2x2 table taking small bowel biopsy as gold standard. Results: In this study the mean age was 4.952 +/- 3.08 years and there were 70(47.95%) male and 76 (52.05%) female patients. Anti-tissue transglutaminase IgA antibodies were present in 84(57.5%) while 88 (60.3%) patients had positive findings on histopathology. There were 81(55.5%) patients who were diagnosed positive on both (histopathological findings and Anti-tissue transglutaminase IgA antibodies) and 55 (37.7%) patients were diagnosed negative on both (histopathological findings and Anti-tissue transglutaminase IgA antibodies). Conclusion: Sensitivity and specificity of anti-tissue transglutaminase IgA antibodies was 92.05% and 94.83% respectively. The overall diagnostic accuracy was 93.15%. So, this test is recommended and should be used for diagnosis of celiac disease in children.