scholarly journals Utility of Tissue Transglutaminase Immunohistochemistry in Pediatric Duodenal Biopsies: Patterns of Expression and Role in Celiac Disease—A Clinicopathologic Review

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Saeeda Almarzooqi ◽  
Ronald H. Houston ◽  
Vinay Prasad
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Transglutaminase 2 ◽  
Surface Epithelium ◽  
Multifunctional Protein ◽  
Cellular Processes ◽  
Significant Difference ◽  
Villous Surface ◽  
Inflammatory Bowel ◽  
Duodenal Biopsies

Tissue transglutaminase (tTG) is a ubiquitous multifunctional protein. It has roles in various cellular processes. tTG is a major target of autoantibodies in celiac disease, and its expression by immunohistochemistry in pediatric celiac disease has not been fully examined. We studied tTG expression in 78 pediatric duodenal biopsies by utilizing an antibody to transglutaminase 2. Serum tTG was positive in all celiac cases evaluated. Serum antiserum endomysial antibody (EMA) and tTG were negative in all control subjects and in inflammatory bowel disease and eosinophilic gastroenteritis. There was a statistically significant difference between cases of celiac disease and normal controls in terms of tTG immunohistochemical staining in duodenal biopsies surface epithelium ( value = 0.0012). There was no significant statistical difference in terms of staining of the villous surface or crypt between the cases of celiac disease and cases with IBD ( value = 0.5970 and 0.5227, resp.). There was no detected correlation between serum tTG values and immunohistochemical positivity on duodenal biopsy in cases of celiac disease ( value = 1). There was no relationship between Marsh classification and positivity of villous surface for tTG ( value = 0.4955). We conclude that tTG has limited utility in diagnosis of celiac disease in pediatric duodenal biopsies.

scholarly journals INCREASED TISSUE TRANSGLUTAMINASE LEVELS ARE ASSOCIATED WITH INCREASED EPILEPTIFORM ACTIVITY IN ELECTROENCEPHALOGRAPHY AMONG PATIENTS WITH CELIAC DISEASE

2015 ◽  
Vol 52 (4) ◽  
pp. 272-277 ◽  
Author(s):  
Sedat IŞIKAY ◽  
Şamil HIZLI ◽  
Serkan ÇOŞKUN ◽  
Kutluhan YILMAZ
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Pearson Correlation ◽  
Epileptiform Activity ◽  
Control Group ◽  
Healthy Children ◽  
Newly Diagnosed ◽  
Laboratory Findings ◽  
Significant Difference ◽  
Medical Histories

Background - Celiac disease is an autoimmune systemic disorder in genetically predisposed individuals precipitated by gluten ingestion. Objective - In this study, we aimed to determine asymptomatic spike-and-wave findings on electroencephalography in children with celiac disease. Methods - A total of 175 children with the diagnosis of celiac disease (study group) and 99 age- and sex-matched healthy children as controls (control group) were included in the study. In order to determine the effects of gluten free diet on laboratory and electroencephalography findings, the celiac group is further subdivided into two as newly-diagnosed and formerly-diagnosed patients. Medical histories of all children and laboratory findings were all recorded and neurologic statuses were evaluated. All patients underwent a sleep and awake electroencephalography. Results - Among 175 celiac disease patients included in the study, 43 were newly diagnosed while 132 were formerly-diagnosed patients. In electroencephalography evaluation of patients the epileptiform activity was determined in 4 (9.3%) of newly diagnosed and in 2 (1.5%) of formerly diagnosed patients; on the other hand the epileptiform activity was present in only 1 (1.0%) of control cases. There was a statistically significant difference between groups in regards to the presence of epileptiform activity in electroencephalography. Pearson correlation analysis revealed that epileptiform activity in both sleep and awake electroencephalography were positively correlated with tissue transglutaminase levels (P=0.014 and P=0.019, respectively). Conclusion - We have determined an increased epileptiform activity frequency among newly-diagnosed celiac disease patients compared with formerly-diagnosed celiac disease patients and control cases. Moreover the tissue transglutaminase levels were also correlated with the presence of epileptiform activity in electroencephalography. Among newly diagnosed celiac disease patients, clinicians should be aware of this association and be alert about any neurological symptoms.

scholarly journals THE PREVALENCE OF CELIAC DISEASE AMONG PATIENTS WITH FAMILIAL MEDITERRANEAN FEVER

2015 ◽  
Vol 52 (1) ◽  
pp. 55-58 ◽  
Author(s):  
Sedat IŞIKAY ◽  
Nurgül IŞIKAY ◽  
Halil KOCAMAZ
Keyword(s):  
Celiac Disease ◽  
Familial Mediterranean Fever ◽  
Tissue Transglutaminase ◽  
Control Group ◽  
Marsh Type ◽  
Significant Difference ◽  
Healthy Control ◽  
Mediterranean Fever ◽  
Relationship Of ◽  
The Relationship

Background Familial Mediterranean Fever and celiac disease are both related to auto-inflammation and/or auto-immunity and they share some common clinical features such as abdominal pain, diarrhea, bloating and flatulence. Objectives We aimed to determine the association of these two diseases, if present. Methods Totally 112 patients diagnosed with Familial Mediterranean Fever and 32 cases as healthy control were included in the study. All participants were examined for the evidence of celiac disease, with serum tissue transglutaminase IgA levels (tTG IgA). Results Totally 144 cases, 112 with Familial Mediterranean Fever and 32 healthy control cases were included in the study. tTG IgA positivity was determined in three cases with Familial Mediterranean Fever and in one case in control group. In that aspect there was no significant difference regarding the tTG IgA positivity between groups (P=0.81). Duodenum biopsy was performed to the tTG IgA positive cases and revealed Marsh Type 3b in two Familial Mediterranean Fever cases and Marsh Type 3c in the other one while the biopsy results were of the only tTG IgA positive case in control group was Marsh Type 3b. In HLA evaluation of the celiac cases; HLA DQ2 was present in two celiac cases of the Familial Mediterranean Fever group and in the only celiac case of the control group while HLA DQ8 was present in one celiac case of the Familial Mediterranean Fever group. Conclusions We did not determine an association of Familial Mediterranean Fever with celiac disease. Larger studies with subgroup analysis are warranted to determine the relationship of these two diseases.

scholarly journals The role of serological tests and biopsy in the diagnosis of celiac disease: retrospective review of 1137 duodenal biopsies

2020 ◽  
Vol 9 (1) ◽  
pp. 27
Author(s):  
Feridun Gurlek ◽  
Eyyup Tasdemir ◽  
Taskın Erkinuresin
Keyword(s):  
Celiac Disease ◽  
Serological Test ◽  
Young Female ◽  
Duodenal Biopsy ◽  
Gluten Sensitivity ◽  
Biopsy Result ◽  
Serological Tests ◽  
Number Of Patients ◽  
Significant Difference ◽  
Duodenal Biopsies

Background: The aim of this study is to evaluate gluten sensitivity and/or celiac disease (CD) on the basis of serological tests and duodenal biopsy and to draw attention to the prevalence in the population and the correlation between serological tests and biopsy results.Methods: Patients who applied to Health Sciences University Bursa High Specialization Training and Research Hospital between 2015-2019 and who underwent serological tests and duodenal biopsies with a diagnosis of CD or gluten sensitivity were retrospectively analyzed.Results: The study was conducted with a total of 1137 cases, 61.2% (n = 696) of who were women and 38.8% (n = 441) were men. Their ages range from 17 to 91, with a mean of 40.16 ± 16.18 years. Of the 178 patients with gluten sensitivity, 122 (68%) were female and 56 (32%) were male. According to the results of duodenal biopsy, an average of 8% Marsh 3, 5% Marsh 1-2 was detected in the last five years. For the whole study, a significant difference was found between celiac autoantibody positivity rates according to the biopsy results (p = 0.001; p <0.01). The rate of serological test positivity was higher in patients with biopsy result Marsh 3 than those with normal biopsy result, peptic duodenitis and Marsh 1 and 2. No statistically significant difference was found between the rates of Marsh 3 biopsy results and serological test positivity by years (p> 0.05).Conclusions: The number of patients applied with a diagnosis of CD in the last five years has gradually increased (3.4-33.7%). Of the patients with Marsh 3 and Marsh 1-2 biopsy results, 78% were under 50 years old. This suggests that gluten enteropathy in young female patients having digestive system complaints should not be ignored during the diagnosis. Serological test results were highly correlated with the biopsy results in patients with Marsh 3 biopsy results. We think that if clinical findings are supported with serological tests and directed for biopsy in the diagnosis of celiac disease, it will be more cost effective and the workload and time loss will be prevented.

scholarly journals A194 PRESENCE OF CELIAC DISEASE IN PATIENTS WITH BARRETT’S ESOPHAGUS IS ASSOCIATED WITH FASTER DEVELOPMENT OF DYSPLASIA AND HIGHER RATES OF ESOPHAGEAL ADENOCARCINOMA

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 65-66
Author(s):  
G H Rueda ◽  
M Wolfe ◽  
A Nardelli ◽  
U Chauhan ◽  
P Moayyedi ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Barrett’S Esophagus ◽  
Esophageal Adenocarcinoma ◽  
Barrett's Esophagus ◽  
Tissue Transglutaminase ◽  
Survival Curve ◽  
Duration Of Treatment ◽  
Digestive Diseases ◽  
Increased Risk ◽  
Duodenal Biopsies

Abstract Background Celiac disease (CD) has an estimated prevalence of 1% worldwide, including North America. Barrett’s esophagus (BE) is a complication of chronic gastroesophageal reflux disease (GERD), which predisposes to development of dysplasia, which can transition to esophageal adenocarcinoma (EAC). GERD is commonly found in patients with CD and there is evidence that reflux symptoms improve after starting the gluten-free diet. However, the prevalence of CD in patients with BE, and its impact on progression to EAC have not been studied. Aims To assess the prevalence of CD in patients with BE and its impact on development of dysplasia and EAC. Methods We performed a retrospective review of medical records of patients attending the Digestive Diseases Clinic and the specialized Barrett’s Clinic at McMaster University Medical Centre. We collected information related to demographics, esophageal and duodenal biopsies, as well as CD serological markers. CD diagnosis was based on the presence of Marsh III lesions in duodenal biopsies and/or positive tissue transglutaminase IgA antibodies (TTG). Categorical data was presented as n/N and %, continuous data as mean ±SD. Logistic regression was performed to estimate the association between BE and CD. For dysplasia development, Kaplan Meyer Breslow survival curve was used. Results CD was found in 1.8% of patients attending the Digestive Diseases Clinic (n=4800). Two hundred and sixteen patients with BE from the Digestive Diseases Clinic and the Barret’s Clinic (age 63 ±11.2, 70.3% males; follow-up period 7.0 ±5.5 years) were included in the analysis. Patients with or without CD were similar in demographic factors, concomitant diseases or previous surgeries, use of PPI, presence of symptoms and duration of treatment. The prevalence of CD was increased 5-fold in patients with BE (OR=6.0; 95% CI 2.1–17.4; p=0.006). BE patients with CD developed dysplasia earlier than those without CD (Long Rank 0.004; mean 6.0; 95% CI 3.0–4.97[PB1]). The risk of EAC was higher in BE patients with CD compared to those without CD (2/11 vs 2/205; OR=22.5; 95% CI 2.8–178.8; p= 0.003). The mean time for development of EAC from the time of BE diagnosis [PB2] was 1.5 years in patients with CD and 6.5 years in patients without CD. Conclusions The prevalence of CD is higher in patients with BE compared with the population attending a tertiary gastroenterology clinic, and with the general population. Patients with BE and concomitant CD are at increased risk of accelerated development of dysplasia and EAC, suggesting that both conditions may have a synergic detrimental effect. Funding Agencies CIHR

scholarly journals THE PREVALENCE OF CELIAC DISEASE IN PATIENTS WITH IRON-DEFICIENCY ANEMIA IN CENTER AND SOUTH AREA OF IRAN

2015 ◽  
Vol 52 (4) ◽  
pp. 278-282 ◽  
Author(s):  
Mahmud BAGHBANIAN ◽  
Ali FARAHAT ◽  
Hasan Ali VAHEDIAN ◽  
Elham SHEYDA ◽  
Mohamad Reza ZARE-KHORMIZI
Keyword(s):  
Celiac Disease ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Significant Relationship ◽  
Tissue Transglutaminase ◽  
Deficiency Anemia ◽  
P Value ◽  
Pathological Changes ◽  
Positive Serology ◽  
Significant Difference

Background - Celiac disease is an immune-mediated enteropathy due to a permanent sensitivity to gluten in genetically susceptible people. Iron-deficiency anemia is the most widely experienced anemia in humans. Iron-deficiency anemia additionally is a common extra intestinal manifestation of celiac disease. Objective - To investigate correlation between tTg levels and histological alterations and then to determine the prevalence of celiac disease in Center and South area patients of Iran with iron deficiency anemia. Methods - A total of 402 patients aged 12-78 years who presented with iron-deficiency anemia were included in this study. Hemoglobin, mean corpuscular volume and serum ferritin were determined. Venous blood samples for anti-tissue transglutaminase antibody immunoglobuline A and G were obtained from these patients. Upper gastrointestinal endoscopy was recommended to patients who had positive serology. Results - Of 402 patients with iron-deficiency anemia, 42 (10.4%) had positive serology for celiac disease. The small intestine biopsy of all patients with positive serology showed pathological changes (Marsh I, II & III). There was not significant difference in the mean hemoglobin level between iron-deficiency anemia patients with celiac disease and without celiac disease, duodenal biopsy results did not show significant relationship between the severity of pathological changes and levels of anti-tTG IgG (P -value: 0/869) but significant relationship was discovered between pathological changes and levels of anti-tTG IgA (P -value: 0/004). Conclusion - Screening of celiac disease by anti-tissue transglutaminase antibody should be completed as a routine investigation in patients with iron-deficiency anemia. Also physicians must consider celiac disease as a possible reason of anemia in all patients with iron deficiency anemia.

The Clinical Significance of Duodenal Lymphocytosis With Normal Villus Architecture

2013 ◽  
Vol 137 (9) ◽  
pp. 1216-1219 ◽  
Author(s):  
Suntrea T. G. Hammer ◽  
Joel K. Greenson
Keyword(s):  
Celiac Disease ◽  
Bacterial Overgrowth ◽  
Antiinflammatory Drug ◽  
Intraepithelial Lymphocytes ◽  
Nonsteroidal Antiinflammatory Drug ◽  
Current Data ◽  
Chronic Inflammatory Bowel Disease ◽  
Wide Range ◽  
Inflammatory Bowel ◽  
Duodenal Biopsies

Context.—The finding of increased intraepithelial lymphocytes with normal villous architecture (Marsh I lesion) is seen in up to 3% of duodenal biopsies. The differential diagnosis includes a wide range of possibilities, including celiac disease, bacterial overgrowth, nonsteroidal antiinflammatory drug damage, reaction to Helicobacter pylori infection, tropical sprue, and chronic inflammatory bowel disease. Objectives.—To highlight the histologic features of the Marsh I lesion, review the diseases and conditions associated with that finding, and to provide pathologists with a rationale and a template for how to identify and report such cases. Data Sources.—A review of the literature regarding the histologic features and clinical associations of Marsh I lesions. Conclusions.—Marsh I lesions are a nonspecific finding associated with a number of disease conditions. Historically, between 9% and 40% of cases have been shown to represent celiac disease. Current data do not suggest histologic features to differentiate between diseases associated with this histologic change.

scholarly journals Celiac Disease and IgA Deficiency: Complications of Serological Testing Approaches Encountered in the Clinic

2008 ◽  
Vol 54 (7) ◽  
pp. 1203-1209 ◽  
Author(s):  
Kelly E McGowan ◽  
Martha E Lyon ◽  
J Decker Butzner
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
False Negative ◽  
Transglutaminase 2 ◽  
Iga Deficiency ◽  
Intestinal Biopsy ◽  
Serological Testing ◽  
Gastrointestinal Pathology ◽  
Serum Iga ◽  
Testing Algorithms

AbstractBackground: IgA deficiency causes false-negative IgA-based celiac serology results in patients with celiac disease. Using a case-finding strategy, we examined the prevalence of IgA deficiency, physician evaluation, and management of IgA deficiency during serological testing for celiac disease.Methods: We reviewed consecutive IgA-endomysial antibody (EMA) and serum IgA results from the laboratory database over 17 months. We cross-referenced seronegative patients with IgA deficiency (IgA &lt;0.06 g/L) to the pathology database to evaluate intestinal biopsy results. Ordering physicians received a questionnaire regarding the management of seronegative patients with IgA deficiency who had no biopsy record.Results: Among the 9533 patients tested for IgA-EMA, 4698 (49%) were tested for IgA deficiency. IgA deficiency occurred in 35 of 4698 (0.75%) patients screened for IgA deficiency. Only 19 of 35 (54%) IgA-deficient patients were diagnosed appropriately with either intestinal biopsy (17 patients) or measurement of IgG-tissue transglutaminase (2 patients). Thirteen (76%) of the 17 IgA-deficient patients who underwent upper endoscopy with or without colonoscopy displayed gastrointestinal pathology on biopsies, including 3 (18%) with celiac disease. No further evaluation to exclude celiac disease was performed for the remaining 16 of 35 (46%) IgA-deficient, EMA-negative patients because of inappropriate management (6 patients), administrative error (7 patients), or patient/physician refusal (3 patients).Conclusions: IgA deficiency occurred in 1:131 patients tested for celiac disease, and celiac disease occurred in 1:6 of those properly evaluated. Inadequate evaluation of IgA deficiency while testing for celiac disease occurred frequently and resulted in the underdiagnosis of both. Changes in testing algorithms and reporting of results were made to improve testing for celiac disease and IgA deficiency.

scholarly journals Intestinal Production of Anti-Tissue Transglutaminase 2 Antibodies in Patients with Diagnosis Other Than Celiac Disease

Nutrients ◽  
2017 ◽  
Vol 9 (10) ◽  
pp. 1050 ◽  
Author(s):  
Mariantonia Maglio ◽  
Fabiana Ziberna ◽  
Rosita Aitoro ◽  
Valentina Discepolo ◽  
Giuliana Lania ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Transglutaminase 2
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