UTILIDAD DE LOS ANTICUERPOS ANTITRANSGLUTAMINASA TISULAR Y SU RELACIÓN CON ENFERMEDAD CELÍACA EN PACIENTES DEL HOSPITAL SAN JUAN DE DIOS DE ENERO DEL 2008 A DICIEMBRE DEL 2010

Abstract

Background: Celiac disease (CD) is a smallintestine enteropathy that is caused by the ingestion of gluten protein in food. The main determinant found is the enzyme tissue transglutaminase, an enzyme of the small intestine. Thisstudy pretends to assess the validity of anti-tTGin patients admitted to HSJD with the diagnosisof CD, because the clinic experience suggests afewer sensitivity as the report in literature. Methods: The population studied was patientstwelve years or older with positive serology foranti-tTG and excluded patients receiving steroidsor immunosuppressive therapy, patients with gastrointestinal surgery, HIV/AIDS or being on aglutenfree diet. We consider patients as havingCD those with symptoms, classic pathological changes and/or a response to freegluten diet. Age, ethnicity, gender and frequency of chronic diseases were documented; and also sensitivity,specificity, PPV and NPV for anti-tTG was measured. A distribution according Marsh histological classification was made. The presence ofIgA deficiency was evaluated. Findings: We found CD was more frequent inwomen and older patients. The sensitivity andspecificity found for anti-tTG IgA was 17% and96%, whereas anti-tTG IgG was 14.2% and100% respectively. The PPV and NPV were 75%and 100% in the case of IgA and 65% and 62.5%for IgG. Most of the histologic specimens wereMarsh 3 or superior. IgA deficiency was notfound. Interpretation: The epidemiologic features in CD were similar to those describe in literature. It was not found classic associated disorders to CD. The validity of anti-tTG for diagnosis of CD waslower as described.