PMID- 24222955
OWN - NLM
STAT- MEDLINE
DCOM- 20140411
LR  - 20211203
IS  - 2219-2840 (Electronic)
IS  - 1007-9327 (Print)
IS  - 1007-9327 (Linking)
VI  - 19
IP  - 41
DP  - 2013 Nov 7
TI  - Children with celiac disease and high tTGA are genetically and phenotypically 
      different.
PG  - 7114-20
LID - 10.3748/wjg.v19.i41.7114 [doi]
AB  - AIM: To investigate whether celiac disease (CD) patients with 
      tissue-transglutaminase antibody (tTGA) >/= 100 U/mL are different from patients 
      with lower tTGA levels. METHODS: Biopsy-proven (Marsh III) pediatric CD patients 
      (n = 116) were prospectively included between March 2009 and October 2012. The 
      biopsies were evaluated by a single pathologist who was blinded to all of the 
      patients' clinical data. The patients were distributed into 2 groups according to 
      their tTGA level, which was measured using enzyme-linked immunoassay: tTGA >/= 100 
      U/mL and tTGA < 100 U/mL. The patients'characteristics, symptoms, human leukocyte 
      antigen (HLA) genotype and degree of histological involvement were compared 
      between the 2 groups. RESULTS: A total of 34 (29.3%) children had tTGA values < 
      100 U/mL and 82 (70.7%) tTGA levels of >/= 100 U/mL. Patients with high tTGA levels 
      had lower average body weight-for-height standard deviation scores (SDS) than did 
      patients with tTGA < 100 U/mL (-0.20 +/- 1.19 SDS vs 0.23 +/- 1.03 SDS, P = 0.025). 
      In the low tTGA group, gastrointestinal symptoms were more common (97.1% vs 
      75.6%, P = 0.006). More specifically, abdominal pain (76.5% vs 51.2%; P = 0.012) 
      and nausea (17.6% vs 3.7%, P = 0.018) were more frequent among patients with low 
      tTGA. In contrast, patients with solely extraintestinal manifestations were only 
      present in the high tTGA group (18.3%, P = 0.005). These patients more commonly 
      presented with aphthous stomatitis (15.9% vs 0.0%, P = 0.010) and anemia (32.9% 
      vs 11.8%, P = 0.019). In addition, when evaluating the number of CD-associated 
      HLA-DQ heterodimers (HLA-DQ2.5, HLA-DQ2.2 and HLA-DQ8), patients with low tTGA 
      levels more commonly had only 1 disease-associated heterodimer (61.8% vs 31.7%, P 
      = 0.005), while patients with high tTGA more commonly had multiple heterodimers. 
      Finally, patients with tTGA >/= 100 U/mL more often had a Marsh IIIc lesion (73.2% 
      vs 20.6%, P < 0.001) while in patients with low tTGA patchy lesions were more 
      common (42.4% vs 6.8%, P < 0.001). CONCLUSION: Patients with tTGA >/= 100 U/mL show 
      several signs of more advanced disease. They also carry a larger number of CD 
      associated HLA-DQ heterodimers.
FAU - Mubarak, Amani
AU  - Mubarak A
AD  - Amani Mubarak, Victorien M Wolters, Roderick HJ Houwen, Department of Pediatric 
      Gastroenterology, University Medical Center Utrecht, Wilhelmina Children's 
      Hospital, 3508 AB Utrecht, The Netherlands.
FAU - Spierings, Eric
AU  - Spierings E
FAU - Wolters, Victorien M
AU  - Wolters VM
FAU - Otten, Henny G
AU  - Otten HG
FAU - ten Kate, Fiebo J W
AU  - ten Kate FJ
FAU - Houwen, Roderick H J
AU  - Houwen RH
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - World J Gastroenterol
JT  - World journal of gastroenterology
JID - 100883448
RN  - 0 (Autoantibodies)
RN  - 0 (HLA Antigens)
RN  - 0 (HLA-DQ Antigens)
RN  - 0 (Immunoglobulin A)
RN  - EC 2.3.2.13 (Protein Glutamine gamma Glutamyltransferase 2)
RN  - EC 2.3.2.13 (Transglutaminases)
RN  - EC 3.6.1.- (GTP-Binding Proteins)
SB  - IM
MH  - Adolescent
MH  - Age Factors
MH  - Asymptomatic Diseases
MH  - Autoantibodies/*blood
MH  - Biopsy
MH  - Celiac Disease/blood/complications/diagnosis/*genetics/*immunology
MH  - Chi-Square Distribution
MH  - Child
MH  - Child, Preschool
MH  - Duodenum/pathology
MH  - Enzyme-Linked Immunosorbent Assay
MH  - Female
MH  - GTP-Binding Proteins
MH  - Genetic Predisposition to Disease
MH  - HLA Antigens/*genetics
MH  - HLA-DQ Antigens/genetics
MH  - Humans
MH  - Immunoglobulin A/*blood
MH  - Infant
MH  - Infant, Newborn
MH  - Male
MH  - Phenotype
MH  - Prospective Studies
MH  - Protein Glutamine gamma Glutamyltransferase 2
MH  - Severity of Illness Index
MH  - Transglutaminases/*immunology
PMC - PMC3819547
OTO - NOTNLM
OT  - Anti-tissue transglutaminase antibodies
OT  - Celiac disease
OT  - Human leukocyte antigen
OT  - Phenotype
OT  - Serology
EDAT- 2013/11/14 06:00
MHDA- 2014/04/12 06:00
PMCR- 2013/11/07
CRDT- 2013/11/14 06:00
PHST- 2013/01/21 00:00 [received]
PHST- 2013/06/18 00:00 [revised]
PHST- 2013/07/04 00:00 [accepted]
PHST- 2013/11/14 06:00 [entrez]
PHST- 2013/11/14 06:00 [pubmed]
PHST- 2014/04/12 06:00 [medline]
PHST- 2013/11/07 00:00 [pmc-release]
AID - 10.3748/wjg.v19.i41.7114 [doi]
PST - ppublish
SO  - World J Gastroenterol. 2013 Nov 7;19(41):7114-20. doi: 10.3748/wjg.v19.i41.7114.