IDDF2022-ABS-0025 A positive association of serum IGG4 levels with degree of mucosal damage based on marsh grading in children with celiac disease. (2nd September 2022)

• Record Type: Journal Article
• Authors: Grotra, Rohan; Gupta, Raj Kumar; Vijay, Priti; Malhotra, Bharti
• Is Part Of: Gut. Volume 71(2022)Supplement 2
• Page Start: A111
• Page End: A111
• Publication Date: 2022-09-02
• Subjects: Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gutjnl-2022-IDDF.144
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Background: Celiac Disease (CD) is an immune-mediated systemic disorder elicited by gluten and related prolamines in genetically susceptible individuals and is characterized by the presence of gluten-enteropathy, CD-specific antibodies, HLA-DQ2/DQ8 haplotypes. IgG4-Related Diseases (IgG4-RD) is an increasingly recognized immune-mediated condition in autoimmune disorders such as primary sclerosing cholangitis, autoimmune hepatitis, and autoimmune thyroiditis, characterized by tissue fibrosclerosis and infiltration by IgG4-positive plasma cells and increased serum IgG4 concentrations. The aim of this study was to investigate the correlation of serum IgG4 levels with Marsh Grading in children with CD. Methods: A total of 33 newly diagnosed CD children and 31 control participants were included in this study. All suspected CD children underwent duodenal biopsy and were diagnosed based on Marsh Grading. Blood samples for serum IgG4 were obtained from all subjects and sera was preserved at -80° C until analysis. Serum IgG4 levels were determined using an enzyme-linked immune sorbent assay method with a diagnostic cut-off of 135 mg/dl. Results: The mean serum IgG4 levels were significantly higher among CD cases (164.49 ± 47.27 mg/dL) compared with controls (78.47 ± 34.71 mg/dL) (p value=0.005) (IDDF2022-ABS-0025 Figure 1. Serum IgG4 levels among cases and controls). Among children with CD, 27/33 (81.8%) and in control group 8/31 (25.8%) had high IgG4 levels (>135 mg/dl, p<0.01). A significant positive association between serum IgG4 levels and Marsh Grading was found, the higher the levels of IgG4 in serum, the higher the grade on Marsh staging. Mean serum IgG4 levels in Marsh 3a was 126.32 mg/dL, in 3b was 171.35 mg/dL and in 3c was 209.24 mg/dL (p value=0.004) (IDDF2022-ABS-0025 Figure 2. Box and whisker plot depicting levels of serum IgG4 in relation with marsh grading). Conclusions: In our study, serum IgG4 levels in CD children were significantly higher as compared with the control group. We also showed for the first time that there was a significant correlation between IgG4 levels and the severity of mucosal damage. To the best of our knowledge, this is the first study to evaluate the relation between IgG4 and mucosal damage in CD in the Paediatric age group.