DIAGNOSTIC ACCURACY OF SERUM IGA ANTI-TISSUE TRANSGLUTAMINASE ANTIBODY IN THE DIAGNOSIS OF CELIAC DISEASE.

Objective: To determine the diagnostic accuracy of serum IgA anti-tissue transglutaminase antibody in the diagnosis of celiac disease taking histopathology as gold standard. Study Design: Cross-sectional survey. Place and Duration of Study: This study was conducted at the department of Pediatrics, Military Hospital Rawalpindi from April 2015 to July 2016. Patients and Methods: Ninety-five consecutive children presenting with suspicion of celiac disease were included in this study after taking written informed consent. A predesigned proforma was used to record patient's demographic details. Anti-tTG level of =25 U/ml was taken as diagnostic of celiac disease while results of histopathology on endoscopic biopsy were taken as gold standard. Results: The mean age of the patients was 6.48 ± 3.20 years and majority (n=53, 55.8%) of the children were aged between 5 to 10 years. The serum anti-tTG level ranged from 8.0 U/ml to 759.0 U/ml with a mean of 298.75 ± 225.51 U/ml. Taking a cut-off value of =25 U/ml for anti-tTG, 81 (85.3%) children were suspected of celiac disease. Histopathology of endoscopic biopsy confirmed celiac disease in 68 (71.6%) children with 62 true positive, 19 false positive, 6 false negative and 8 true negative cases. It yielded 91.18% sensitivity, 29.63% specificity and 73.68% accuracy for anti-tTG (=25 U/ml) in the diagnosis of celiac disease with positive and negative predictive values of 76.54% and 57.14% respectively. Conclusion: IgA anti-tissue transglutaminase antibody (=25 U/ml) was found to be highly sensitive test for the detection of celiac disease in children. [ABSTRACT FROM AUTHOR]