ArticleJournal of gastroenterology2016
Identification of a serum transglutaminase threshold value for the noninvasive diagnosis of symptomatic adult celiac disease patients: a retrospective study.
Article in Journal of gastroenterology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 30 citations in OpenAlex.
- Biopsy-Sparing Diagnosis of Coeliac Disease Based on Endomysial Antibody Testing and Clinical Risk Assessment.Alimentary pharmacology & therapeutics · 2025Article
- Exploring Total Immunoglobulin A's Impact on Non-Biopsy Diagnosis of Celiac Disease: Implications for Diagnostic Accuracy.Nutrients · 2024Article
- Non-biopsy Strategy for the Diagnosis of Celiac Disease in Adults: A Narrative Review.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2024Review
- Feasibility of a "No-Biopsy" Approach for the Diagnosis of Celiac Disease in Symptomatic Adults.Cureus · 2024Article
- Review
- The Gluten-Free Diet for Celiac Disease: Critical Insights to Better Understand Clinical Outcomes.Nutrients · 2023Review
- Article
- Article
- Serologic diagnosis of celiac disease: May it be suitable for adults?World journal of gastroenterology · 2021Review
- May Antitransglutaminase Levels Predict Severity of Duodenal Lesions in Adults with Celiac Disease?Medicina (Kaunas, Lithuania) · 2021Article
- Discordance Between Serology and Histology for Celiac Disease in a Cohort with Coexisting Liver Disorders.Journal of the Canadian Association of Gastroenterology · 2020Article
- Article
- Comparison of non-invasive tests with invasive tests in the diagnosis of celiac disease.Journal of clinical laboratory analysis · 2019Article
- Diagnosis of Celiac Disease: Taking a Bite Out of the Controversy.Digestive diseases and sciences · 2018Review
- Celiac disease in non-clinical populations of Japan.Journal of gastroenterology · 2018Article
- The serological diagnosis of coeliac disease - a step forward.Gastroenterology and hepatology from bed to bench · 2018Review
- Application of the Biopsy-Sparing ESPGHAN Guidelines for Celiac Disease Diagnosis in Adults: A Real-Life Study.Digestive diseases and sciences · 2017Article
- Current Espghan Guidelines for Celiac Disease in Pediatric Age, Tertiary Care Center Experience: A Proposal for Further Simplification.Translational medicine @ UniSaArticle
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA celiac disease (CD) diagnosis is based on duodenal histology, with the exception of children showing anti-tissue transglutaminase (anti-tTG) serum levels exceeding ten times the cut-off. Our aim was to reproduce this simplified approach in adults, identifying an anti-tTG threshold value useful to diagnose CD without endoscopic procedures.
methodsA total of 671 adult CD patients were subjected to blood sampling to determine anti-tTG serum levels, as well as to endoscopy with biopsy to perform duodenal histology. The anti-tTG serum levels/cut-off ratio was compared with the degree of duodenal lesions.
resultsAnti-tTG serum levels/cut-off ratio determined in patients with type IIIc was significantly higher than that measured in patients with type IIIb (p < 0.001), IIIa (p < 0.001), II (p < 0.05) and 0 (p < 0.001) of Marsh-Oberhuber histological classification. A significant correlation (r = 0.297, p < 0.0001) was found between the anti-tTG serum levels/cut-off ratio and the degree of duodenal lesions. The anti-tTG serum levels/cut-off ratio was classified as an accurate parameter (AUC = 0.715, p < 0.0001), with the best diagnostic performance obtained considering the threshold value >3.6 (sensitivity = 76.8 %, PPV = 97.2 %).
conclusionsThe anti-tTG serum levels/cut-off ratio correlates with the degree of duodenal lesions and, if used with the threshold value >3.6, could avoid endoscopy with biopsy in about 75 % of seropositive adults waiting for CD diagnosis. However, since this procedure could also imply CD diagnosis in almost 3 % of seropositive patients with normal villous architecture, a consensus opinion is needed to suggest its use in the diagnosis of adult CD.
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