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Serum intestinal fatty acid–binding protein in the noninvasive diagnosis of celiac disease
Author(s) -
Oldenburger Irene B.,
Wolters Victorien M.,
KardolHoefnagel Tineke,
Houwen Roderick H. J.,
Otten Henny G.
Publication year - 2018
Publication title -
apmis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 88
eISSN - 1600-0463
pISSN - 0903-4641
DOI - 10.1111/apm.12800
Subject(s) - tissue transglutaminase , medicine , biopsy , gastroenterology , fatty acid binding protein , disease , pathology , biology , biochemistry , gene , enzyme
Current diagnostic guidelines for celiac disease ( CD ) in pediatric patients require a duodenal biopsy if the IgA anti‐tissue transglutaminase ( tTG ) is below 10x the upper limit of normal ( ULN ). Additional markers may enable a noninvasive diagnosis in this group. Serum intestinal‐fatty acid‐binding protein (I‐ FABP ), a marker for intestinal epithelial damage, could be useful in this respect. A total of 95 children with a clinical suspicion of CD and tTG 1‐10x ULN were investigated. All had a duodenal biopsy and analysis of serum I‐ FABP . A control group of 161 children with familial short stature and normal tTG was included. I‐ FABP levels in the 71 patients with tTG 1‐10x ULN and biopsy‐proven CD (median 725 pg/mL) were not significantly different (p = 0.13) from the levels in the 24 patients with a tTG 1‐10x ULN but a normal biopsy (median 497 pg/mL). However, when combining tTG and I‐ FABP levels, 11/24 patients could have been diagnosed noninvasively if tTG is ≥ 50 U/mL and I‐ FABP ≥880 pg/mL or in 12/19 patients if tTG is ≥ 60 U/mL and I‐ FABP ≥ 620 pg/mL. Therefore, addition of I‐ FABP to the diagnostic procedure of CD may provide a noninvasive diagnosis in patients with a tTG ≥ 50 U/mL.