Correlation of Anti-Tissue Transglutaminase Antibodies With the Mucosal Changes and IgA Status of Children With Celiac Disease. Issue 6 (20th September 2022)

• Record Type: Journal Article
• Authors: Donat, Ester; Roca, María; Castillejo, Gemma; Sánchez-Valverde, Félix; García-Burriel, Jose Ignacio; Martínez-Ojinaga, Eva; Eizaguirre, Francisco Javier; Barrio, Josefa; Cilleruelo, Mª Luz; Pérez-Solís, David; Ochoa-Sangrador, Carlos; Vecino-López, Raquel; Miranda-Cid, Mª del Carmen; García-Calatayud, Salvador; Torres-Peral, Ricardo; Juste, Mercedes; Armas, Honorio; Barros-García, Patricia; Leis, Rosaura; Solaguren, Rosa; Salazar, José Carlos; García-Romero, Ruth; Ortigosa, Luis; Peña-Quintana, Luis; Urruzuno, Pedro; Codoñer-Franch, Pilar; Garcia-Casales, Zuriñe; Masiques, Maria Llüisa; Galicia-Poblet, Gonzalo; Crehuá-Gaudiza, Elena; Balmaseda, Elena; Rubio-Santiago, Javier; Polanco-Allué, Isabel; Román-Riechmann, Enriqueta; Ribes-Koninckx, Carmen;
• Is Part Of: Journal of pediatric gastroenterology and nutrition. Volume 75:Issue 6(2022)
• Page Start: 743
• Page End: 748
• Publication Date: 2022-09-20
• Subjects: diagnosis -- multicenter study -- registry -- serology; Children -- Nutrition -- Periodicals; Pediatric gastroenterology -- Periodicals; Infants -- Nutrition -- Periodicals; Nutrition disorders in children -- Periodicals; Child Nutrition -- Periodicals; Digestive System -- growth & development -- Periodicals; Gastrointestinal Diseases -- Periodicals; Infant Nutrition -- Periodicals; Nutrition Disorders -- Periodicals; Child; 618.923
• DOI: 10.1097/MPG.0000000000003620
• Languages: English
• ISSNs: 0277-2116

Abstract

Abstract : Objectives: The objective of this study was to assess the association between serological markers and changes of the intestinal mucosa in children with celiac disease (CD). Methods: Clinical data from CD patients under 15 years old were collected from the participating centers in an on-line multicenter nationwide observational Spanish registry called REPAC-2 (2011–2017). Correlation between anti-tissue transglutaminase antibodies (t-TGA) levels and other variables, including mucosal damage and clinical findings (symptoms, age, and gender), was assessed. Results: A total of 2955 of 4838 patients had t-TGA and a small bowel biopsy (SBB) performed for CD diagnosis. A total of 1931 (66.2%) patients with normal IgA values had a Marsh 3b-c lesion and 1892 (64.9%) had t-TGA Immunoglobulin A (IgA) ≥ 10 times upper limit of normal (ULN). There is a statistically significant association between t-TGA IgA levels and the degree of mucosal damage ( P < 0.001), the higher the t-TGA IgA levels the more severe the mucosal damage. Those patients who reported symptoms had more severe mucosal damage ( P = 0.001). On the contrary, there was a negative association between age and changes of the intestinal mucosa ( P < 0.001). No association was found with gender. Regarding the IgA-deficient patients, 47.4% (18 cases) had t-TGA Immunoglobulin A (IgA) ≥ 10 times ULN and a Marsh 3b-c lesion was observed in 68.4% (26 patients). No statistical relation was found between t-TGA IgG levels and the changes of the intestinal mucosa, neither a relation with age, gender, or symptoms. Conclusions: There is a positive correlation between t-TGA IgA levels and the severity of changes of the intestinal mucosa. Such correlation was not found in IgA-deficient patients who had positive t-TGA IgG serology. The results in this group of patients support the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition recommendations about the need of performing a SBB in IgA-deficient individuals despite high t-TGA IgG levels.