Journal article

Publication year: 2018

Pages: 1442-144+

Journal: Clinical Gastroenterology and Hepatology

Volume number: 16

Issue number: 9

ISSN: 1542-3565

eISSN: 1542-7714

Open access status: Hybrid

DOI Link: https://doi.org/10.1016/j.cgh.2018.04.008

Publisher: Elsevier

Abstract: 

BACKGROUND & AIMS: Celiac disease can be identified by a serologic test for IgA against tissue transglutaminase (IgA-TTG) in a large proportion of children. However, the increased concentrations of antibody rarely normalize within the months after children are placed on a gluten-free diet (GFD). Early serologic predictors of sufficient adherence to gluten-free diet are required for optimal treatment.

METHODS: In a prospective study, we observed the response to a GFD in 345 pediatric patients (67% girls; mean age, 8.4 y) who underwent duodenal biopsy to confirm or refute celiac disease from October 2012 through December 2015. Baseline serum samples were tested centrally for IgA-TTG and IgG against deamidated gliadin. Follow-up serologic analyses of children on a GFD were performed about 3 months later.

RESULTS: The geometric mean concentration of IgA-TTG decreased from 72.4-fold to 5.2-fold the upper limit of normal (ULN), or by a factor of 14.0 (95% CI, 12.0-16.4). A substantial response (defined as a larger change than the typical variation in patients not on a GFD) was observed in 80.6% of the children. Only 28.1% of patients had a substantial response in the concentration of IgG against deamidated gliadin. Concentration of IgA-TTG remained above 1-fold the ULN in 83.8% of patients, and above 10-fold the ULN in 26.6% of patients with a substantial response.

CONCLUSIONS: Serum concentration of IgA-TTG decreases substantially in most children with celiac disease within 3 months after they are placed on a GFD, but does not normalize in most. This information on changes in antibody concentrations can be used to assess patient response to the diet at short-term follow-up evaluations. Patients with a substantial response to a GFD often still have high antibody levels after 3 months.

Harvard Citation style: Petroff, D., Wolf, J., Richter, T., Auth, M., Uhlig, H., Laass, M., et al. (2018) Antibody Concentrations Decrease 14-Fold in Children With Celiac Disease on a Gluten-Free Diet but Remain High at 3 Months, Clinical Gastroenterology and Hepatology, 16(9), pp. 1442-144+. https://doi.org/10.1016/j.cgh.2018.04.008

APA Citation style: Petroff, D., Wolf, J., Richter, T., Auth, M., Uhlig, H., Laass, M., Lauenstein, P., Krahl, A., Haendel, N., de Laffolie, J., Hauer, A., Heiduk, M., Flemming, G., Schmidt, A., Hasenclever, D., & Mothes, T. (2018). Antibody Concentrations Decrease 14-Fold in Children With Celiac Disease on a Gluten-Free Diet but Remain High at 3 Months. Clinical Gastroenterology and Hepatology. 16(9), 1442-144+. https://doi.org/10.1016/j.cgh.2018.04.008