The 2013 American College of Gastroenterology guidelines and the American Gastroenterology Association recommend that tests for anti-tTG
and anti-DPG should be part of routine testing for celiac disease[sup.
6) Currently, anti-TTG
IgA is used as the primary antibody in the diagnosis of celiac disease.
14) Patients with an IgA deficiency should be screened for celiac disease with a reliable anti-tTG
Currently, to confirm a diagnosis of classic celiac disease, the titers of circulating antigliadin, antiendomysial, and/or anti-tTG
immunoglobulin (Ig) A or IgG antibodies are determined.
The IgA anti-tTG
provides the best specificity and is widely used.
In patients, upon hemolysis, the endogenous RBC-tTG released may immunoprecipitate with anti-tTG
antibodies and interfere with their detection.
3-5) This has led to the development of the dot-blot test for this anti-tTG
antibody, which has a sensitivity of 98% and specificity of 99%.
Though the definitive diagnosis of the celiac disease is based in characteristic histological changes observed in intestinal biopsies, the serological tests, such as the detection of antibodies anti-gliadins, anti-tTG
and anti-endomysium, represent methods of analyses cheaper and less invasive to the detection of the disease.
3) Given that antibody levels typically decrease over time with the removal of gluten from the diet, levels of anti-tTG
or anti-DGP antibodies will often be followed to ensure that they decline or turn negative altogether.
Five of the 26 DH patients had a nonpathologic duodenal histology (Marsh type 0), and 7 patients were seronegative for anti-tTG
Several studies have shown that a gluten-free diet, which decreases anti-tTG
levels, directly correlates with increased bone mass in patients with celiac disease and low bone mineral density, he said.
In individuals with symptoms suggestive of CD, the first-line approach to diagnosis is the determination of specific anti-tTG
antibodies of class IgA in patient serum.