Anti-tissue transglutaminase antibodies in the follow-up of adult coeliac disease.

Abstract

BACKGROUND The detection of auto antibodies directed against tissue transglutaminase (anti-tTG antibodies) has a well-established role in the diagnosis of coeliac disease, but the value of these antibodies in long-term follow-up is controversial. AIMS To determine if serial anti-tTG antibody measurements could confirm adherence to a gluten-free diet (GFD) and identify patients at risk of disease complications. METHODS In a 54-month cohort follow-up study, 182 adult patients were assessed. Data recorded included self-assessment of GFD adherence; anti-tTG antibody concentration and serum ferritin, vitamin B12 and folate. Where available, bone mineral density (BMD) and duodenal histology data were retrieved. RESULTS Persistently elevated anti-tTG antibody levels were significantly associated with abnormal duodenal histology (P < 0.001), low ferritin (P < 0.01) and poor adherence to the GFD (P < 0.001). The specificity was >85% while the sensitivity was 39-60%. Anti-tTG antibody concentrations fell rapidly following successful initiation of a GFD, and maintenance of normalization identified those who continued to be adherent to the diet. CONCLUSIONS This study supports a strategy of using anti-tTG antibody concentrations to monitor newly diagnosed and established patients with coeliac disease, and to target dietetic intervention to reduce the risk of complication.

DOI: 10.1111/j.1365-2036.2009.04039.x
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@article{Dipper2009AntitissueTA, title={Anti-tissue transglutaminase antibodies in the follow-up of adult coeliac disease.}, author={Christian Dipper and Sushir Maitra and Rowan D Thomas and Christopher Andrew Lamb and Andrew P. C. Mclean-Tooke and Rosemary Ward and D. Alastair Smith and Gavin P Spickett and John C. Mansfield}, journal={Alimentary pharmacology & therapeutics}, year={2009}, volume={30 3}, pages={236-44} }