1. Arslaan Javaeed 2. Walayat Shah 3. Rizwan Akhtar 4. Sanniya Khan Ghauri 5. Shafqat Husnain Khan 6. Aftab Haider Alvi

1.  Histopathologist, Fatima Memorial Hospital / FMMC, Lahore 2. Asstt. Prof. of Pathology, KMU, Peshawar  3. Prof. of Pathology, FMMC, Lahore 4. Resident of Emergency Medicine, AKUH, Karachi 5. Senior Demonstrator of Pathology, CMC, Lahore 6. Asstt. Prof. of Medicine, FMMC, Lahore

ABSTRACT

Objective: The objective of this study was to assess the diagnostic accuracy of most widely used serological test for diagnosis of celiac disease (CD) i.e. anti-tissue transglutaminase antibody (IgA) in comparison to histopathological lesions in CD.

Study Design: cross sectional study

Place and Duration of Study: This study was carried out at the Departments of Gastroenterology and Pathology of Fatima Memorial Hospital, Shadman, Lahore from March 2014 to October 2014.

Materials and Methods: 121 patients clinically suspected of celiac disease were included in this cross sectional study. The biopsy was taken from the second part of duodenum and was evaluated according to Marsh classification of CD. Blood sample of every patient was obtained to perform anti-tTG antibody test.

Results: The range of the patients included in the study came out to be 18-65 years with 30.24 years as mean age. Out of all the patients included in this study 34 (28.1%) were males and 87(71.9%) were females. The overall sensitivity and specificity of anti-tTG were 78.6% and 98.1%.The positive predictive value (PPV) and negative predictive value (NPV) came out to be 84.6% and 97.2% respectively.

Conclusion: We have come to the conclusion that currently there is no serological test which can be used as a sole tool for the diagnosis of celiac disease. Relying on serological test will lead to missed diagnosis of CD especially those patients which have Marsh lesions of lesser degrees.

Key Words: Celiac Disease, Anti-Tissue Transglutaminase Antibody, Sensitivity, Duodenal Biopsy.