Diagnostic accuracy of IgA anti-tissue transglutaminase in celiac disease in Van-Turkey

Although the IgA anti-tissue transglutaminase test (IgA anti-Ttg) has been recommended as the first step in the diagnosis of celiac disease (CD), there are controversial data about the real accuracy of the test in clinical practice. Therefore we evaluated the sensitivity and specificity of the IgA anti-Ttg in a group of patients who were suspected of having CD. The study was performed at Van Training and Research Hospital, Van-Turkey. Details of patients in whom the IgA anti-Ttg was requested from January 2009 to April 2012 were obtained from databases. Duplicate requests were excluded. Histopathologic examination of duodenal biopsies and serologic evaluations were compared. A total of 1614 IgA anti-Ttg were requested from different patients. In all, 49.6% of requests were in females and 29.8% from children under the age of sixteen. A total of 192 (11.9%) requests were found to be positive. Duodenal biopsies were performed to 61 (31.8%) of seropositive patients. The overall sensitivity and specificity of IgA anti-Ttg were 93.3% and 9.5%. Our data have revealed that clinicians should be aware of solely relying on the results of the IgA anti-Ttg test could result in unnecessary diagnostic procedures and treatments.