Is the Diagnosis of Celiac Disease Possible Without Intestinal Biopsy?
Journal Title: Balkan Medical Journal - Year 2017, Vol 34, Issue 4
Abstract
Background: Coeliac disease is defined as a state of immune-mediated hyper-responsiveness to dietary gluten from wheat, barley, or rye in genetically predisposed individuals that results in tissue damage. The diagnosis is made by microscopic examination of a small intestinal biopsy, although serological testing for antibodies against tissue transglutaminase and deamidated gliadin peptide can be of great advantage. It has been suggested that duodenal biopsy can be avoided in patients with high levels of the tissue transglutaminase antibody, since a relationship has been found to be present between tissue transglutaminase antibody titres and coeliac disease. Aims: To study the correlation between tissue transglutaminase titre and small intestinal biopsy findings in patients with coeliac disease. Study Design: Diagnostic accuracy study. Methods: Ninety-five cases of patients diagnosed with coeliac disease and with positive serum tissue transglutaminase titres were retrieved from the Jordan University Hospital archives between December 2014 and December 2015. All the cases were classified according to the Marsh classification. Results: Ninety-five cases with a positive titre for the antibody were included in this study, 73 (76.8%) of them were females and 22 cases (23.2%) were males. The age of the patients ranged between 4 and 75 years with a mean age ± standard deviation of 32.3±14.7. The sensitivity was the highest in Marsh IIIC and lowest in Marsh IIIA (95% versus 68% respectively). The specificity was moderate (76%) for all subtypes of Marsh III. Conclusion: This study showed a positive correlation between the tissue transglutaminase titre and the degree of duodenal damage (Marsh IIIC) in patients with coeliac disease. In the presence of high tissue transglutaminase levels, duodenal biopsy might not be always necessary for diagnosis, particularly in symptomatic patients.
Authors and Affiliations
Maha Shomaf, Mohammad Rashid, Dana Faydi, Ahmad Halawa
Keywords
Related Articles
- EP ID EP380472
- DOI 10.4274/balkanmedj.2016.1258
- Views 56
- Downloads 0
Comparison of Two Intraocular Lens Implantation Techniques in Pediatric Cataract Surgery in Terms of Postoperative Complications
Background: Pediatric cataract surgery differs substantially from adult cataract surgery. Numerous studies have focused on reducing the development of postoperative complications. Aims: To compare two intraocular lens i...
Fetal Complex Congenital Heart Disease Diagnosed Using Prenatal Ultrasound and Corrosion Casting for Large Vessels: A Report for Authentic Teaching by True Representation
.
Giant J (Osborn) Wave due to Bonsai Abuse: Comments on Clinical Practice
Background: Osborn wave, typically associated with hypothermia, is currently referred to as one of the J wave syndromes due to its clinical potential to develop lethal cardiac arrhythmia; it may rarely be observed in a n...
Validation of Transition Readiness Assessment Questionaire in Turkish Adolescents with Diabetes
Background: Today, more than 90% of adolescents with chronic conditions survive into adulthood and move from pediatric care to adult care for the management of their chronic illness. It is important to grant autonomy and...
The Knowledge Level and Opinions of Physicians about the Medical and Legal Procedures Related to Physical Child Abuse
Background: In order to diagnose child abuse, physicians need to consider the possibility of abuse in every child they encounter, have sufficient information about the topic and manage the cases according to current law....