COMPARATIVE EVALUATION OF SEROLOGICAL MARKERS AND DUODENAL HISTOPATHOLOGY IN DIAGNOSING CELIAC DISEASE AND OUTCOMES OF GLUTEN-FREE DIET
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Keywords
Celiac disease, anti-tTG antibodies, duodenal biopsy, gluten-free diet, serological markers
Abstract
Background: Celiac disease (CD) is a long-lasting autoimmune enteropathy activated by gluten in genetically susceptible human beings. Timely and proper diagnosis and gluten-free diet (GFD) are essential to be controlled.
Objectives: To evaluate and compare diagnostic value of serological biomarkers (anti-tTG) and duodenal biopsy in CD along with patient improvement over time with a GFD.
Methods: In this study, the cross-sectional design took place in June 2020 through December 2021 at Pakistan Atomic Energy Commission (PAEC) General Hospital. One-hundred and fifty patients with either clinically suspected or confirmed CD were recruited. Duodenal histology, serology and clinical symptoms were assessed. Patients were monitored upto six months in order to determine the GFD adherence and response.
Study Design: A Cross sectional study. Place and Duration of study. June 2020 through December 2021 at Pakistan Atomic Energy Commission (PAEC) General Hospital, Islamabad.
Results: Among 150 patients with mean age of 28.5± 9.7 years, 63% were female patients.68% patients presented with diarrhea, 54% abdominal pain, and 48% with weight loss.94 % had high anti-tTG (mean: 55.6 ±12.4 U/mL) and 88% had a biopsy-proven villous atrophy (p < 0.01). At six months of GFD, 76 % of patients showed symptomatic improvement, and 84 % had normalized serological markers (p < 0.001).
Conclusion: Serological markers (anti-tTG) are sensitive diagnostic markers and show high concordance with duodenal biopsy and are also useful screening tests. A strict GFD is effective in enhancing clinical and laboratory outcomes. There should be gender-specific management strategies.
References
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