Correlation between cut-off level of tissue transglutaminase antibody and marsh classification

Background: Duodenal biopsy is required for diagnosis of celiac disease in adults, although some studies have suggested adequate accuracy of serology alone

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Objective: We aimed to assess the correlation between anti-tissue transglu-taminase [tTG] titer and pathological findings and to define the specific level of tTG for predicting celiac disease in adults without the need for biopsy sampling

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Methods: This descriptive study was done on 299 participants

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The tTG titer and pathological findings of duodenal biopsy samples were used for this study Analysis of Receiver operating characteristic [ROC] curve was used to find a cut-off point of anti-tTG antibody for mucosal atrophy

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Results: Mean tTG titers was significantly higher in patients graded as Marsh III>/= 3 [p=0.023]. ROC curve analysis showed 89.1% sensitivity for cut-off point>/=76.5 lU/mL of anti-tTG. For Marsh>/= II, specificity was 28% and positive predictive value was 91%

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Conclusion: There is a linear correlation between increasing tTG level and Marsh I to III. Specificity of tTG titer more than 200 was 100% for Marsh >2.