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Prevalence and clinical significance of IgA anti‐tissue transglutaminase antibodies in patients with chronic liver disease
Author(s) -
Sood Ajit,
Khurana Manbir Singh,
Mahajan Ramit,
Midha Vandana,
Puri Sandeep,
Kaur Amandeep,
Gupta Nishit,
Sharma Suresh
Publication year - 2017
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13474
Subject(s) - medicine , tissue transglutaminase , cirrhosis , gastroenterology , biopsy , liver biopsy , disease , immunopathology , liver disease , chronic liver disease , pathology , biochemistry , chemistry , enzyme
Background and Aim Celiac disease is a multi‐systemic disease, which can affect any organ system including liver. However, the prevalence of celiac disease and the sensitivity and specificity of anti‐tissue transglutaminase (anti‐tTG) in diagnosing celiac disease in patients with cirrhosis of liver is not well established. Methods We screened a cohort of patients with chronic liver disease for an associated diagnosis of celiac disease. Anti‐tTG was carried out in all patients, and those with a high value were subjected to duodenal biopsy for histological confirmation. In patients where biopsy was contraindicated or refused, anti‐endomysial antibody (anti‐EMA) was tested. Results Of a total of 595 patients with chronic liver disease, high levels of anti‐tTG were noted in 150 (25.2%) patients, and celiac disease was diagnosed in 14 patients (2.4%). Celiac autoimmunity (high levels of both anti‐tTG and anti‐EMA) was noted in seven patients (1.2%). Conclusions Although a large number of cirrhotic patients have high levels of anti‐tTG, duodenal histology and/or anti‐EMA is normal in majority of these patients. This suggests high false positivity of anti‐tTG in patients with cirrhosis and highlights the need of duodenal biopsy for histological confirmation of the diagnosis of celiac disease.