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Dig Liver Dis. 2011 Aug;43(8):604-8. doi: 10.1016/j.dld.2011.01.015. Epub 2011 Feb 20.

Intestinal deposits of anti-tissue transglutaminase IgA in childhood celiac disease.

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  • 1Department of Pediatrics and European Laboratory for the Investigation of Food-Induced Diseases, University "Federico II", Naples, Italy.



High serum levels of anti-tissue-transglutaminase-2 IgA antibodies (anti-TG2), which are produced and deposited in the intestine, characterize celiac disease.


To assess the diagnostic value of intestinal deposits of anti-TG2 IgA for celiac disease in a paediatric population.


344 children underwent duodenal biopsy for the suspicion of CD, and were divided into 3 groups: group A, 144 celiac subjects with villous atrophy (Marsh 3b-c); group B, 109 subjects with high serum levels of anti-TG2 but normal intestinal mucosa (Marsh 0-1) (potential celiac disease patients); group C, 91 subjects with normal levels of serum anti-TG2: 70 with Marsh 0-1 and 21 with Marsh 3a mucosa. All duodenal sections were evaluated for the presence of intestinal deposits of anti-TG2 IgA by double immunofluorescence.


Deposits of anti-TG2 IgA were present in 96%, 68%, 12% of patients from groups A, B, C, respectively. Diagnostic sensitivity and specificity for celiac disease were 96% and 88% vs. 97% and 100% for serum anti-TG2, respectively. The degree of concordance with serum anti-TG2 was 85%.


Detection of intestinal deposits of anti-TG2 IgA is a useful diagnostic tool. Further research is needed regarding their ability to predict evolution to villous atrophy in potential celiac disease.

Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

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