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Feasibility of a “No-Biopsy” Approach for the Diagnosis of Celiac Disease in Symptomatic Adults

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Publicado en:Cureus vol. 16, no. 2 (2024)
Autor principal: Punia Parul
Otros Autores: Bala Kiran, Verma Mansi, Nandi Ankita, Mahlotra Parveen, Singh, Sunita, Garg Seema, Parmar Aparna, Kumar, Devender
Publicado:
Springer Nature B.V.
Materias:
India
Histology
Antigens
Antibodies
Pediatrics
Celiac disease
Serology
Biopsy
Medical research
Medical diagnosis
Teenagers
Acceso en línea:Citation/Abstract
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Resumen: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.Material and methods: 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.Results: 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.Conclusion: Serum levels of anti-tTGA antibodies greater than 10 x ULN can be used to identify symptomatic patients with Marsh grade 3 CD lesions.
ISSN:2168-8184
2154-4786
DOI:10.7759/cureus.54578
Fuente:Health & Medical Collection