Indian Journal of Gastroenterology最新文献

{"title":"Female liver transplant recipients are at increased risk of developing cervical cancer: A global multicenter study.","authors":"Ami K Patel, Katherine M Cooper, Charanpreet K Sasan, Jenna Patel, Deepika Devuni","doi":"10.1007/s12664-025-01842-z","DOIUrl":"https://doi.org/10.1007/s12664-025-01842-z","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of gastrointestinal PCR in inflammatory bowel disease flares: A double-edged sword or a diagnostic breakthrough?","authors":"Manjeet Kumar Goyal, Elliot Berinstein, Priyata Dutta, Vineet Ahuja, Peter D R Higgins, Jeffrey Berinstein, Shrinivas Bishu","doi":"10.1007/s12664-025-01811-6","DOIUrl":"https://doi.org/10.1007/s12664-025-01811-6","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), is characterized by chronic gastrointestinal inflammation, leading to unpredictable flares and substantial morbidity. Gastrointestinal polymerase chain reaction (GI-PCR) testing has emerged as a widely used diagnostic tool to identify enteric pathogens during IBD exacerbations. It is a novel, quick and sensitive diagnostic test to detect Clostridioides difficile infection (CDI), as well as other enteric pathogens. However, the clinical significance of non-C. difficile pathogens detected by GI-PCR remains uncertain, raising concerns about the over-interpretation of positive results and the potential for unnecessary antimicrobial therapy. While traditional stool culture and microscopy offered limited sensitivity, GI-PCR has dramatically improved pathogen detection rates, identifying infections in up to 26% of IBD patients compared to 5% with conventional methods. Beyond C. difficile, pathogens such as Escherichia coli (especially adherent-invasive strains), Campylobacter, Salmonella, Norovirus and Yersinia enterocolitica are frequently detected in IBD flares. However, whether these microbes actively drive disease exacerbations or merely reflect inflammation-associated dysbiosis remains unclear. Enterobacteriaceae, in particular, bloom in inflamed intestines, raising critical questions regarding their pathogenic role vs. colonization. The high sensitivity of GI-PCR further complicates clinical decision-making, as distinguishing active infection from harmless microbial presence is challenging. This review explores the current literature on GI-PCR in IBD, emphasizing its benefits and limitations. While GI-PCR provides rapid, comprehensive pathogen detection, its indiscriminate application may lead to unnecessary antibiotic use and therapeutic missteps. Understanding the ecological shifts in IBD-associated dysbiosis and refining clinical interpretation of GI-PCR results are essential to optimizing patient management. Future research should aim to delineate the pathogenic significance of non-C. difficile microbes and establish evidence-based protocols for the appropriate use of GI-PCR in IBD care.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic resonance imaging to differentiate between Crohn's disease-associated and cryptoglandular perianal fistula.","authors":"Arshdeep Singh, Chandan Kakkar, Pietro A Bonaffini, Arshia Bhardwaj, Ashi Sachdeva, Mahima Marwah, Namita Bansal, Ramit Mahajan, Kirandeep Kaur, Anuraag Jena, Kavita Saggar, Gursimran Singh Kochhar, Bo Shen, Vandana Midha, Ajit Sood","doi":"10.1007/s12664-025-01809-0","DOIUrl":"https://doi.org/10.1007/s12664-025-01809-0","url":null,"abstract":"<p><strong>Background: </strong>The radiological features of Crohn's disease (CD)-associated and cryptoglandular perianal fistulae (PAF) are similar, but distinguishing them is crucial for treatment decisions. Delayed CD diagnosis in PAF can worsen long-term outcomes and accurate radiological differentiation may help identify CD-associated PAF.</p><p><strong>Methods: </strong>In a retrospective single-center study, we analyzed the pelvic MRI images of the patients with PAF. Logistic regression analysis was performed to identify MRI parameters with independent predictive value for CD-associated PAF. Statistically significant magnetic resonance imaging (MRI) parameters from the model, along with their corresponding coefficients, were used to develop the \"DMC index\" for differentiating between CD-associated and cryptoglandular PAF.</p><p><strong>Results: </strong>Out of the 287 MRI screened for eligibility, 119 cases, including 32 (26.89%) patients with an established clinical diagnosis of CD, were analyzed. On multivariate logistic regression analysis, ≥ 2 internal openings of the fistula tract, rectal thickening and distance of the mucosal origin from the anal verge > 1.85 cm predicted the PAF to be associated with CD. The DMC index, with a threshold of ≥ 1.5, demonstrated strong discriminatory ability for CD-associated PAF (sensitivity 65%; specificity 94%; area under curve 0.88 [95% CI 0.81-0.95; p < 0.0001]).</p><p><strong>Conclusion: </strong>The DMC index effectively identifies CD-associated PAF with high specificity, ensuring minimal false positives and strong diagnostic reliability. Integrating this index with additional diagnostic modalities may facilitate earlier CD diagnosis in patients presenting with PAF, potentially improving long-term clinical outcomes.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical utility of thiopurine metabolite levels in monitoring patients with inflammatory bowel disease: A single-centre retrospective study.","authors":"Khushboo G Upadhyay, Mihika B Dave, Devendra C Desai, Prasad R Naik, Swarup A V Shah, Minal U Paradkar, Sarita D Pol, Philip Abraham, Satish G Kulkarni, Nutan D Desai, Dhanashri N Shetty, Tester F Ashavaid, Alpa J Dherai","doi":"10.1007/s12664-025-01831-2","DOIUrl":"https://doi.org/10.1007/s12664-025-01831-2","url":null,"abstract":"<p><strong>Background: </strong>Therapeutic drug monitoring (TDM) of thiopurines is crucial for optimizing inflammatory bowel disease (IBD) treatment. Despite its benefits, data on thiopurine levels in Indian IBD patients is limited. Thus, we assessed 6-thioguanine nucleotide (6-TGN) and 6-methyl mercaptopurine (6-MMP) levels in patients on thiopurine therapy and evaluated their correlation with dosage and clinical outcome.</p><p><strong>Methods: </strong>6-TGN and 6-MMP levels in IBD patients (2016-2024) were measured using an in-house high-pressure liquid chromatography (HPLC) method. Levels were then correlated with clinical data, disease activity and genotyping to assess the impact of metabolite monitoring on clinical outcomes and therapy management.</p><p><strong>Results: </strong>Of the 638 samples evaluated from 418 IBD patients, 6-TGN levels were sub-therapeutic in 323, therapeutic in 163 and supra-therapeutic in 99. A majority (~ 90%) of patients on 1-2 mg/kg and > 2 mg/kg doses achieved therapeutic levels than those on < 1 mg/kg, though no correlation with disease activity was found. Repeat monitoring in 132 patients led to dose adjustments in 71 due to toxicity, low 6-TGN, disease control or shunting. Genotyping was done in 130 patients. Thiopurine toxicity caused discontinuation in 34 patients (11%), with nine cases linked to thiopurine methyltransferase/nucleoside diphosphate-linked moiety X-type motif 15 (TPMT/NUDT15) variants.</p><p><strong>Conclusion: </strong>Only one-third of patients on thiopurine therapy reached therapeutic levels and 6-TGN levels did not correlate with remission. Most patients had sub-therapeutic 6-TGN levels, resulting in poor disease control despite on recommended doses. Literature-defined 6-TGN targets may be insufficient for Indian IBD patients. Larger studies are needed to determine the optimal 6-TGN target and therapeutic threshold for remission in our population.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of tirzepatide for weight loss and it's comparative effectiveness to weight loss surgery in inflammatory bowel disease.","authors":"Aakash Desai, Himsikhar Khataniar, Fjona Tabaku, Jana G Hashash, Francis A Farraye, Gursimran S Kochhar","doi":"10.1007/s12664-025-01835-y","DOIUrl":"https://doi.org/10.1007/s12664-025-01835-y","url":null,"abstract":"<p><strong>Background and aims: </strong>There is limited data about tirzepatide's (TZP) efficacy for weight loss in patients with inflammatory bowel disease (IBD).</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using the US Collaborative Network in patients with IBD on TZP between January 5, 2022 and December 31, 2023. The objective was to assess mean total body weight (TBW) change in pounds (lbs) in the IBD TZP cohort compared to the non-IBD TZP cohort and IBD cohort with weight loss surgery (WLS) from baseline to between six and 15 months. 1:1 propensity score matching was performed for demographics, comorbid conditions, body mass index (BMI) and body weight.</p><p><strong>Results: </strong>There were 274 patients in the IBD TZP cohort (mean age 53.6 ± 11.9, 66.4% diabetes mellitus, BMI 38.3 ± 7.7 kg/m²). There was no difference in the TBW change between the IBD and non-IBD cohort on TZP (-21 lbs [ 95% CI -30 to -12] vs. -21 lbs [-30 to -11], p = 1.0). There was no difference in the TBW based on time interval, IBD type, IBD medications, surgery and TZP dose. There was a lower TBW change compared to the IBD WLS cohort (-21 lbs [-36 to -5] vs. -55 lbs [-68 to -41], p < 0.0001). There was higher TBW change with 15 mg TZP (-29 lbs [-45 to -12]) compared to 5-10 mg TZP (-15 lbs [-36 to 6]), however, lower compared to the IBD WLS cohort.</p><p><strong>Conclusion: </strong>TZP use was associated with a similar mean weight loss of > 10% in patients with IBD compared to patients without IBD, however lower compared to WLS.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic burden borne by patients due to diagnostic delays in inflammatory bowel disease: Insights from a survey of newly diagnosed patients.","authors":"Vijesh V S, Noble Varghese Mathews, Nicholas Vijay Rao, David Mathew Thomas, Anoop John, Jasmin Helan Prasad, Kanagalakshmi V, Rajeeb Jaleel, Amit Kumar Dutta, Ebby George Simon, A J Joseph","doi":"10.1007/s12664-025-01822-3","DOIUrl":"https://doi.org/10.1007/s12664-025-01822-3","url":null,"abstract":"<p><strong>Background and objective: </strong>Patients with inflammatory bowel disease (IBD) often experience diagnostic delays owing to the absence of a definitive test. In our country, it is compounded by difficulty in differentiating it from tuberculosis, in certain situations. Hence, we decided to specifically estimate the economic burden that patients with IBD must bear until definitive treatment is initiated.</p><p><strong>Methods: </strong>This prospective observational study included all consecutive patients with newly diagnosed IBD aged 18 years or older from October 2021 to December 2024. Details regarding symptom onset, investigations and treatments were collected using a structured questionnaire. Details regarding direct medical, direct non-medical and indirect costs were collected.</p><p><strong>Results: </strong>Ninety-seven patients, mean age 38.7 ± 13.5 years, median symptom duration 15 (7-38.5) months, were included in this study. Crohn's disease (CD) and ulcerative colitis (UC) were present in 55 (56.7%) and 42 (43.3%) patients, respectively. The median (interquartile range [IQR]) per capita monthly household income of the study population in rupees (Rs) was 5000 (3333-12,250). The economic burden due to diagnostic delay was Rs 136,029 (81,863-213,979), which amounted to 5.5 (2.3-9.2) times the monthly household income. The total direct medical, direct non-medical and indirect costs were Rs 69,610 (39,297-110,809), Rs 26,400 (14,238-45,340) and Rs 24,000 (10500-58210), respectively. The diagnostic delay for patients with CD was 3.4 times greater than that for patients with UC (27 [12-60] months vs. 8 [3-20] months; p < 0.001). Patients with CD suffered a greater economic burden than UC patients (Rs 162,750 [116,618-287,630] vs. Rs 96,752 [57,555-145,671]; p < 0.001) and required more visits to the doctor before the diagnosis was made (9 [7-14] vs. 5 [4-8.25]; p < 0.001).</p><p><strong>Conclusion: </strong>The economic burden of diagnostic delays in patients with IBD is a major problem. Patients with CD experienced longer delays, had more hospital visits and spent more money prior to the initiation of disease-specific therapy than those with UC.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute pancreatitis: Translating early mechanisms to bedside management.","authors":"Rupjyoti Talukdar","doi":"10.1007/s12664-025-01826-z","DOIUrl":"https://doi.org/10.1007/s12664-025-01826-z","url":null,"abstract":"<p><p>Acute pancreatitis (AP) is a burgeoning challenge. The first week of the disease is generally considered early AP. Events that occur during this phase can determine the magnitude of subsequent events. Even after decades of research, there is still no curative therapy for early AP. One of the earliest events of clinical AP is the co-localization of zymogen and trypsinogen within autophagolysosome which is followed by trypsin activation. The resulting acinar injury releases damaged-associated molecular patterns (DAMPs) that trigger cytokine production by the resident immune cells. Concurrently, there will be neutrophil infiltration, endothelial dysfunction and capillary leak. The local intra-pancreatic inflammation will activate the circulating mononuclear cells traversing the inflamed pancreas and in turn, get activated and perpetuate the systemic inflammatory response syndrome (SIRS). This eventually triggers organ damage. Concurrently, another phenomenon called compensatory anti-inflammatory response syndrome (CARS) ensues, that makes the patient susceptible to infections including infected necrosis. CARS is characterized by the downregulation of human leukocyte antigen (HLA)-DR and results in immunosuppression. The intestine also has a substantial role in determining the severity progression of systemic events in AP. The three components of the intestine that have been implicated include gut mucosal barrier, the microbiota and intestinal lymph. Intestinal inflammation occurs as a part of SIRS and results in the loss of tight junctions and apoptosis of the intestinal epithelial cells thereby increasing the mucosal permeability. Meanwhile, there will be gut microbial dysbiosis resulting in the translocation of pathogens and pathogen-associated molecular patterns (PAMPS) into the circulation. This would result in infections, which was already facilitated by CARS. In addition, the intestinal lymph could also result in translocation of intestinal toxins to the systemic circulation thereby contributing to the severity of AP. This narrative review discusses the current understanding of the mechanisms of early AP and the clinical implications.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary non-hepatoblastoma liver tumors in children-Defining the profile of a very rare subset of childhood tumors.","authors":"Abha Mehta, Badira Cheriyalinkal Parambil, Akshay Baheti, Venkata Ram Mohan Gollamudi, Maya Prasad, Vasundhara Patil, Sajid Qureshi, Mukta Ramadwar, Poonam Panjwani, Kunal Gala, Siddhartha Laskar, Nehal Khanna, Jifmi Jose Manjali, Sneha Shah, Girish Chinnaswammy","doi":"10.1007/s12664-025-01823-2","DOIUrl":"https://doi.org/10.1007/s12664-025-01823-2","url":null,"abstract":"<p><strong>Background: </strong>Primary pediatric non-hepatoblastoma (n-HB) liver tumors are rare with limited literature on their clinical-epidemiological profile and outcomes. We audit the above in this study.</p><p><strong>Methods: </strong>Children diagnosed with n-HB primary liver tumors from January 2012 to December 2023 were analyzed retrospectively. Patients underwent contrast-enhanced computed tomography (CECT) of the abdomen and computed tomography (CT) of the thorax or fluorodeoxyglucosepositron emission tomography/computed tomography (FDG-PET/CT) for staging of malignant tumors. Treatment was administered based on the definitive diagnosis.</p><p><strong>Results: </strong>Sixty-nine patients formed the study cohort. The most common tumors in various age groups were infantile hepatic hemangioma (IHH)-66.7%, malignant rhabdoid tumor (MRT)-25%; six months to three years: MRT-25.0%, mesenchymal hamartoma and hemangioendothelioma-18.7% each; three to 10 years: hepatocellular carcinoma (HCC)-31.6%, undifferentiated embryonal sarcoma of the liver (UESL)-26.3%; and > = 10 years: HCC-45.4%, UESL-22.7%. Median alpha-fetoprotein (AFP) level in HCC was 131,249 ng/mL. Treatment was delivered to 65.8% patients. Chemotherapy for treated malignant tumors was administered in 81.5%, surgery in 85.2% and radiotherapy in 18.5%, alone or combined. In the different malignant cancer sub-types, the proportion of relapse/deaths in treated patients was HCC-22.2%, UESL-33.3%, rhabdoid-25%, hemangioendotheliomas-25% and sarcomas-25%.</p><p><strong>Conclusions: </strong>There was a high proportion of malignant rhabdoid tumors and higher serum AFP levels in HCC in our cohort. The overall outcomes of treated malignant tumors were relatively favorable, though limited by the sample size in this rare cohort.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A deeper quiet: Tofacitinib and the potential of endo-histologic remission.","authors":"Syed Adeel Hassan, Shrinivas Bishu","doi":"10.1007/s12664-025-01792-6","DOIUrl":"https://doi.org/10.1007/s12664-025-01792-6","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of intestinal fatty acid binding protein in the non-invasive diagnosis of celiac disease in children.","authors":"Sanjeevani Kaul, Rohan Malik, Tapish Pandey, Savita Saini, Alka Singh, Prasenjit Das, Govind Makharia","doi":"10.1007/s12664-025-01796-2","DOIUrl":"https://doi.org/10.1007/s12664-025-01796-2","url":null,"abstract":"<p><strong>Objectives: </strong>Intestinal fatty acid binding protein (IFABP) is a marker of intestinal epithelial injury and has been studied as a surrogate for predicting villous atrophy. The aim of this study was to evaluate the utility of IFABP in the non-invasive diagnosis of celiac disease (CeD) in children.</p><p><strong>Methods: </strong>Symptomatic children with positive anti-tissue transglutaminase antibody underwent a duodenal biopsy and IFABP measurement. Controls were included who had both tissue transglutaminase antibody (tTG) and IFABP measured. We evaluated the performance of IFABP in the diagnosis of CeD by generating the receiver operating characteristic (ROC) curve.</p><p><strong>Results: </strong>Total 123 children were screened; 98 had a positive anti-tTG, 74 patients aged 8.5 ± 4.0 years were diagnosed to have CeD and 24 patients had a normal biopsy. Seventy-six children aged 8.4 ± 4.0 years were enrolled as controls. Serum IFABP was significantly higher in children with CeD; median 918 pg/mL (interquartile range [IQR] = 630-1316) as compared to controls; median 386 pg/mL (IQR = 125-581) (p < 0.001). We observed increasing serum IFABP levels with a higher Marsh grade of mucosal injury (p < 0.001). Sensitivity and specificity for diagnosis of CD were 51% and 88% at serum IFABP level > 920 pg/mL and area under the curve (AUC) of 0.79 (0.67-0.90). In children with CD and a tTG 1-10 of normal, this cut-off could make a diagnosis without biopsy in 28/34 cases.</p><p><strong>Conclusion: </strong>Serum IFABP can improve the non-invasive diagnosis of CeD in children with elevated tTG-IgA titers in a subset of patients and also has good correlation with the degree of villous atrophy.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}