Diagnostic utility of anti-tissue transglutaminase antibodies in children with chronic digestive symptoms and suspected of celiac disease

Abstract

Introduction: Celiac disease is the most common chronic enteropathy in the world, but its occurrence in children with chronic gastrointestinal symptoms in our environment is unknown. Objective: To evaluate the diagnostic utility of anti-tissue transglutaminase antibodies in children with chronic digestive symptoms. Methods: A prospective study was carried out from January 2008 to April 2011 at the José Luis Miranda Pediatric University Hospital in Santa Clara. It included 535 infants in which anti-tissue transglutaminase antibodies was screened. Duodenal transendoscopic biopsies were taken, which were interpreted according to the Marsh-Oberhuber classification and were related to the serological test. The diagnostic efficacy of the antibodies was assessed and the frequency of celiac disease was estimated. Results: Only 11 patients were positive for antibody determination (2.1%). The predominant type of anatomo-pathologic lesion in patients who were positive for antibodies was typical of celiac disease (9 boys, 75%). There was an agreement between the serological and histopathological diagnosis of the duodenum (K=0.78, p<0.001). The frequency of celiac disease in the series was 2.2% (12 patients). The sensitivity and specificity of the antibodies was 75% and 99% respectively. Conclusions: There was a low frequency of celiac disease in the series, and a good diagnostic accuracy of the serological tests in children suspected of suffering the disease was achieved.