Tissue transglutaminase immunoglobulin A testing is a sensitive adjunct to the diagnosis of celiac disease.
The threshold for positivity was developed for diagnosis, with negative results reported as below the reference value.
Dr Murray and colleagues from Rochester, USA investigated if an undetectable is more predictive of healing compared to patients with negative but detectable serology.
The research team performed a retrospective study of 402 treated celiac disease patients seen at the Mayo Clinic with negative tissue transglutaminase immunoglobulin A values drawn within 1 month of duodenal biopsy between 2009 and 2015.
The Corazza-Villanacci score was used to assess mucosal healing.
|Gluten-free diet for 2 years or more was more likely to have no villous atrophy|
|Alimentary Pharmacology & Therapeutics|
The presence of gastrointestinal symptoms was also collected.
Logistic regression was used to assess the relationship of clinical variables with a normal biopsy.
The research team found that patients with undetectable titres more frequently had normal duodenal histology compared to patients with detectable tissue transglutaminase immunoglobulin A levels.
The team noted that asymptomatic patients more frequently had normal duodenum as compared to symptomatic patients.
Patients with undetectable serology, and on a gluten-free diet for 2 years or more were more likely to have no villous atrophy compared to patients with detectable serology.
Dr Murray's team concluded, "In subjects recovering from celiac disease with negative tissue transglutaminase immunoglobulin A serology, an undetectable titre is associated with normal histology on follow-up biopsy".