Maria Nyholm Iversen, Katrine Stribolt, Christian Lodberg Hvas, Anders Dige
{"title":"IgA抗组织转谷氨酰胺酶诊断乳糜泻的准确性。","authors":"Maria Nyholm Iversen, Katrine Stribolt, Christian Lodberg Hvas, Anders Dige","doi":"10.61409/A03250187","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>A no-biopsy approach has been suggested for diagnosing coeliac disease (CD) in adult patients. This approach is already well established in diagnosing children with CD. This study aimed to evaluate the accuracy of IgA anti-tissue transglutaminase (IgA anti-tTG) in predicting duodenal mucosal lesions diagnostic of CD in adult patients.</p><p><strong>Methods: </strong>We included all patients aged ≥ 18 years referred for CD diagnostics at our department in the period from 1 January 2019 to 31 December 2023 with raised IgA anti-tTG levels and in whom duodenal biopsies had been evaluated for CD-specific lesions. Data regarding IgA anti-tTG levels and duodenal histology evaluated by the modified Marsh classification were retrieved from the patient records.</p><p><strong>Results: </strong>A total of 235 adult patients had positive IgA anti-tTG levels and an available duodenal histology. High IgA anti-tTG levels (> 10 × upper limit of normal (ULN)) were associated with more severe enteropathy. The PPV of IgA anti-tTG for identifying Marsh ≥ 2 or 3 lesions increased when the serological cut-off was raised. The positive predictive value of IgA anti-tTG > 10 × ULN was 99.2% (95% CI: 95.8-100%) and 97.7% (95% CI: 93.4-99.5%) for predicting Marsh ≥ 2 and 3 lesions, respectively.</p><p><strong>Conclusions: </strong>This study confirms that high titers of IgA anti-tTG may accurately identify adults with diagnostic duodenal mucosal lesions associated with CD. Our data support the use of a no-biopsy approach for diagnosing CD in adults with high IgA anti-tTG titers.</p><p><strong>Funding: </strong>None.</p><p><strong>Trial registration: </strong>Not relevant.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"72 9","pages":""},"PeriodicalIF":1.2000,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Diagnostic accuracy of IgA anti-tissue transglutaminase for the diagnosis of coeliac disease.\",\"authors\":\"Maria Nyholm Iversen, Katrine Stribolt, Christian Lodberg Hvas, Anders Dige\",\"doi\":\"10.61409/A03250187\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>A no-biopsy approach has been suggested for diagnosing coeliac disease (CD) in adult patients. This approach is already well established in diagnosing children with CD. This study aimed to evaluate the accuracy of IgA anti-tissue transglutaminase (IgA anti-tTG) in predicting duodenal mucosal lesions diagnostic of CD in adult patients.</p><p><strong>Methods: </strong>We included all patients aged ≥ 18 years referred for CD diagnostics at our department in the period from 1 January 2019 to 31 December 2023 with raised IgA anti-tTG levels and in whom duodenal biopsies had been evaluated for CD-specific lesions. Data regarding IgA anti-tTG levels and duodenal histology evaluated by the modified Marsh classification were retrieved from the patient records.</p><p><strong>Results: </strong>A total of 235 adult patients had positive IgA anti-tTG levels and an available duodenal histology. High IgA anti-tTG levels (> 10 × upper limit of normal (ULN)) were associated with more severe enteropathy. The PPV of IgA anti-tTG for identifying Marsh ≥ 2 or 3 lesions increased when the serological cut-off was raised. The positive predictive value of IgA anti-tTG > 10 × ULN was 99.2% (95% CI: 95.8-100%) and 97.7% (95% CI: 93.4-99.5%) for predicting Marsh ≥ 2 and 3 lesions, respectively.</p><p><strong>Conclusions: </strong>This study confirms that high titers of IgA anti-tTG may accurately identify adults with diagnostic duodenal mucosal lesions associated with CD. Our data support the use of a no-biopsy approach for diagnosing CD in adults with high IgA anti-tTG titers.</p><p><strong>Funding: </strong>None.</p><p><strong>Trial registration: </strong>Not relevant.</p>\",\"PeriodicalId\":11119,\"journal\":{\"name\":\"Danish medical journal\",\"volume\":\"72 9\",\"pages\":\"\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2025-08-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Danish medical journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.61409/A03250187\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Danish medical journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.61409/A03250187","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Diagnostic accuracy of IgA anti-tissue transglutaminase for the diagnosis of coeliac disease.
Introduction: A no-biopsy approach has been suggested for diagnosing coeliac disease (CD) in adult patients. This approach is already well established in diagnosing children with CD. This study aimed to evaluate the accuracy of IgA anti-tissue transglutaminase (IgA anti-tTG) in predicting duodenal mucosal lesions diagnostic of CD in adult patients.
Methods: We included all patients aged ≥ 18 years referred for CD diagnostics at our department in the period from 1 January 2019 to 31 December 2023 with raised IgA anti-tTG levels and in whom duodenal biopsies had been evaluated for CD-specific lesions. Data regarding IgA anti-tTG levels and duodenal histology evaluated by the modified Marsh classification were retrieved from the patient records.
Results: A total of 235 adult patients had positive IgA anti-tTG levels and an available duodenal histology. High IgA anti-tTG levels (> 10 × upper limit of normal (ULN)) were associated with more severe enteropathy. The PPV of IgA anti-tTG for identifying Marsh ≥ 2 or 3 lesions increased when the serological cut-off was raised. The positive predictive value of IgA anti-tTG > 10 × ULN was 99.2% (95% CI: 95.8-100%) and 97.7% (95% CI: 93.4-99.5%) for predicting Marsh ≥ 2 and 3 lesions, respectively.
Conclusions: This study confirms that high titers of IgA anti-tTG may accurately identify adults with diagnostic duodenal mucosal lesions associated with CD. Our data support the use of a no-biopsy approach for diagnosing CD in adults with high IgA anti-tTG titers.
期刊介绍：
The Danish Medical Journal (DMJ) is a general medical journal. The journal publish original research in English – conducted in or in relation to the Danish health-care system. When writing for the Danish Medical Journal please remember target audience which is the general reader. This means that the research area should be relevant to many readers and the paper should be presented in a way that most readers will understand the content.
DMJ will publish the following articles:
• Original articles
• Protocol articles from large randomized clinical trials
• Systematic reviews and meta-analyses
• PhD theses from Danish faculties of health sciences
• DMSc theses from Danish faculties of health sciences.
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