Punia Parul, Bala Kiran, Verma Mansi, Nandi Ankita, Mahlotra Parveen, Singh Sunita, Garg Seema, Parmar Aparna, Kumar Devender
Microbiology, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, IND.
Gastroenterology, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, IND.
Cureus. 2024 Feb 20;16(2):e54578. doi: 10.7759/cureus.54578. eCollection 2024 Feb.
Celiac disease (CD) is an immune-mediated enteropathy, caused by hypersensitivity to gluten in genetically predisposed individuals. The worldwide prevalence of CD has been estimated to be approximately 1%. Most guidelines for diagnosis of CD rely on a sequential approach, with serological testing of antibodies against tissue transglutaminase (tTG) as a first-line test, followed by a duodenal biopsy. However, GI biopsy is an invasive procedure with various complications. Hence, this study was planned to ascertain whether it could be possible to have a non-biopsy approach, using only serological markers to establish the diagnosis of CD in adults.
It was a retrospective analysis of medical records of all biopsy-diagnosed CD patients with available anti-tTGA antibodies reports from 2019 to 2023. The patients were divided into three groups based on Marsh grading and anti-tTGA antibody levels were compared using various statistical tests.
A total of 94 biopsy-diagnosed symptomatic CD patients with anti-tTGA antibody reports available formed the study group. Of these, 54 had biopsy findings consistent with Marsh 3 lesion, three had Marsh 2 lesion, and 37 had Marsh 1 lesion. A significant correlation existed between Marsh grading 3 lesion and anti-tTGA antibody levels above the upper limit of normal (ULN) x 10.
Serum levels of anti-tTGA antibodies greater than 10 x ULN can be used to identify symptomatic patients with Marsh grade 3 CD lesions.
乳糜泻（CD）是一种免疫介导的肠病，由遗传易感性个体对麸质的超敏反应引起。据估计，CD在全球的患病率约为1%。大多数CD诊断指南依赖于序贯方法，首先进行针对组织转谷氨酰胺酶（tTG）抗体的血清学检测作为一线检测，随后进行十二指肠活检。然而，胃肠道活检是一种有各种并发症的侵入性操作。因此，本研究旨在确定是否有可能采用仅使用血清学标志物的非活检方法来确诊成人CD。
这是一项对2019年至2023年所有经活检确诊且有可用抗tTGA抗体报告的CD患者病历的回顾性分析。根据马什分级将患者分为三组，并使用各种统计检验比较抗tTGA抗体水平。
共有94例经活检确诊且有抗tTGA抗体报告的有症状CD患者组成了研究组。其中，54例患者的活检结果与马什3级病变一致，3例为马什2级病变，37例为马什1级病变。马什3级病变与抗tTGA抗体水平高于正常上限（ULN）×10之间存在显著相关性。
