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Anti-tissue transglutaminase antibodies in the follow-up of adult coeliac disease

Lookup NU author(s): Dr Sohom Maitra, Dr Chris LambORCiD, Dr Andrew McLean-Tooke, Dr Gavin Spickett, Dr John Mansfield


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Background The detection of auto antibodies directed against tissue transglutaminase (anti-tTG antibodies) has a well-established role in the diagnosis of coeliac disease, but the value of these antibodies in long-term follow-up is controversial. Aims To determine if serial anti-tTG antibody measurements could confirm adherence to a gluten-free diet (GFD) and identify patients at risk of disease complications. Methods In a 54-month cohort follow-up study, 182 adult patients were assessed. Data recorded included self-assessment of GFD adherence; anti-tTG antibody concentration and serum ferritin, vitamin B12 and folate. Where available, bone mineral density (BMD) and duodenal histology data were retrieved. Results Persistently elevated anti-tTG antibody levels were significantly associated with abnormal duodenal histology (P 85% while the sensitivity was 39-60%. Anti-tTG antibody concentrations fell rapidly following successful initiation of a GFD, and maintenance of normalization identified those who continued to be adherent to the diet. Conclusions This study supports a strategy of using anti-tTG antibody concentrations to monitor newly diagnosed and established patients with coeliac disease, and to target dietetic intervention to reduce the risk of complication.

Publication metadata

Author(s): Dipper CR, Maitra S, Thomas R, Lamb CA, McLean-Tooke APC, Ward R, Smith D, Spickett G, Mansfield JC

Publication type: Article

Publication status: Published

Journal: Alimentary Pharmacology and Therapeutics

Year: 2009

Volume: 30

Issue: 3

Pages: 236-244

ISSN (print): 0269-2813

ISSN (electronic): 1365-2036

Publisher: Wiley-Blackwell Publishing Ltd.


DOI: 10.1111/j.1365-2036.2009.04039.x


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