Evidence map›Paper›PMID 40774665›Full record

ArticlePediatrics2025

Positive Predictive Value of Tissue Transglutaminase IgA for Celiac Disease.

Denis Chang, Madison Wong, Maria Camila Cardenas, Marisa G Stahl, Edwin Liu, Mayan Caplan, Dominica Gidrewicz, James A King, Justine M Turner, Maureen M Leonard and 13 more

Abstract readMulticenter Study
In one paragraph

Article in Pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Denis ChangDivision of Gastroenterology and Nutrition, Boston Children's Hospital, Boston, Massachusetts.
Madison WongDivision of Gastroenterology and Nutrition, Boston Children's Hospital, Boston, Massachusetts.
Maria Camila CardenasDivision of Gastroenterology and Nutrition, Boston Children's Hospital, Boston, Massachusetts.
Marisa G StahlDigestive Health Institute, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
Edwin LiuDigestive Health Institute, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
Mayan CaplanDigestive Health Institute, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
Dominica GidrewiczSection of Pediatric Gastroenterology, Hepatology & Nutrition, Alberta Children's Hospital, Department of Pediatrics, University of Calgary, Calgary, Alberta.
James A KingAlberta Strategy for Patient Oriented Research Support Unit Data Platform, Calgary and Edmonton, Alberta, Canada; Provincial Research Data Services, Alberta Health Services, Calgary and Edmonton, Alberta, Canada; Centre for Health Informatics, University of Calgary, Calgary, Alberta.
Justine M TurnerDivision of Pediatric Gastroenterology and Nutrition, Stollery Children's Hospital, Edmonton, Alberta.
Maureen M LeonardCenter for Celiac Research and Treatment, Division of Pediatric Gastroenterology and Nutrition, Mass General Hospital for Children, Harvard Medical School, Boston, Massachusetts.
Dale LeeDivision of Pediatric Gastroenterology and Hepatology, Seattle Children's Hospital, Seattle, Washington.
M Cristina PachecoDepartment of Laboratory Medicine and Pathology, Seattle Children's Hospital, Seattle, Washington.
Jane DickersonDepartment of Laboratory Medicine and Pathology, Seattle Children's Hospital, Seattle, Washington.
Catherine RaberCeliac Disease Program, Division of Gastroenterology, Hepatology, and Nutrition, Children's National Hospital, Washington, D.C.
Vahe BadalyanCeliac Disease Program, Division of Gastroenterology, Hepatology, and Nutrition, Children's National Hospital, Washington, D.C.
Ankur ChughDivision of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Medical College of Wisconsin, Children's Wisconsin, Milwaukee, Wisconsin.
Mala SettyDivision of Pediatric Gastroenterology, Hepatology and Nutrition, UCSF Benioff Children's Hospitals, Oakland, California.
Clara BaekDivision of Gastroenterology and Nutrition, Boston Children's Hospital, Boston, Massachusetts.
Arunjot SinghDivision of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Lisa FaheyDivision of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Catharine M WalshDivision of Gastroenterology, Hepatology and Nutrition and the Research and Learning Institutes, The Hospital for Sick Children, Department of Paediatrics and the Wilson Centre, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario.
Jocelyn A SilvesterDivision of Gastroenterology and Nutrition, Boston Children's Hospital, Boston, Massachusetts.
Imad AbsahDivision of Pediatric Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.

Funding

Prospective Multi-Omic Analysis of At-Risk infants to Model Celiac Disease PathogenesisK23DK122127 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI LEONARD, MAUREEN MICHELLE · 2019 to 2023
$1.2M
Mechanisms and Markers of Small Intestinal Epithelial Injury and Villous AtrophyK23DK119584 · NIDDK · BOSTON CHILDREN'S HOSPITAL · PI SILVESTER, JOCELYN ANNE · 2019 to 2023
$971k
NIDDK NIH HHS K23 DK119584NIDDK NIH HHS K23 DK122127
6 · The paper itself

Abstract

BACKGROUND AND

objectivesRecent changes in European diagnostic criteria allow for serologic diagnosis of celiac disease in children. Those guidelines have not been adopted in North America; hence, we aim to assess the positive predictive value (PPV) of tissue transglutaminase (tTG) immunoglobulin A (IgA) assays used in North America in identifying histologic findings of celiac disease.

methodsMulticenter retrospective cohort study of children (<18 years) with an elevated tTG IgA within 6 months of an esophagogastroduodenoscopy between January 2016 and December 2021. Biopsy-confirmed celiac disease was determined by the presence of intraepithelial lymphocytosis and villous atrophy. The primary outcomes were the PPV of an elevated tTG IgA and tTG IgA greater than or equal to 10 times the upper limit of normal (10× ULN).

resultsOverall, 4019 children (63.3% female; 9% type 1 diabetes, 2% Down syndrome) were included. Histologic findings were consistent with celiac disease for 3321 children (PPV = 82.6% [95% CI, 81.4-83.8]). Among the 1739/4019 (43.2%) children with tTG IgA greater than or equal to 10× ULN, 1651 had biopsy-confirmed celiac disease (PPV10× = 94.9% [95% CI, 93.8-95.9]). Five percent (88/1739) of children did not have histologic findings of celiac disease, including 41/1739 (2%) with normal histology. Diagnostic accuracy of tTG IgA varied widely among assays used in North America (PPV range: 71.5%-88.8%; PPV10× range: 89.3%-97.3%). Assays performed worse in children with type 1 diabetes (PPV10× 89% [95% CI, 83.5-92.8]).

conclusionsElevated tTG IgA in isolation is insufficient to confidently diagnose celiac disease. As tTG assay performance varied widely, diagnostic confirmation by a specialist prior to dietary changes is essential.

Indexed as

Celiac DiseaseGTP-Binding ProteinsImmunoglobulin ATransglutaminasesAdolescentBiomarkersBiopsyChildChild, PreschoolCohort StudiesFemaleHumansInfantMalePredictive Value of TestsProtein Glutamine gamma Glutamyltransferase 2BiomarkersGTP-Binding ProteinsImmunoglobulin AProtein Glutamine gamma Glutamyltransferase 2Transglutaminases

Identifiers

PMID40774665
PMCPMC13155385

What OpenQuestion holds

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LicenceTDM
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.