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Lookup NU author(s): Dr Sohom Maitra, Professor Chris LambORCiD, Dr Andrew McLean-Tooke, Dr Gavin Spickett, Dr John Mansfield
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Background The detection of auto antibodies directed against tissue transglutaminase (anti-tTG antibodies) has a well-established role in the diagnosis of coeliac disease, but the value of these antibodies in long-term follow-up is controversial. Aims To determine if serial anti-tTG antibody measurements could confirm adherence to a gluten-free diet (GFD) and identify patients at risk of disease complications. Methods In a 54-month cohort follow-up study, 182 adult patients were assessed. Data recorded included self-assessment of GFD adherence; anti-tTG antibody concentration and serum ferritin, vitamin B12 and folate. Where available, bone mineral density (BMD) and duodenal histology data were retrieved. Results Persistently elevated anti-tTG antibody levels were significantly associated with abnormal duodenal histology (P 85% while the sensitivity was 39-60%. Anti-tTG antibody concentrations fell rapidly following successful initiation of a GFD, and maintenance of normalization identified those who continued to be adherent to the diet. Conclusions This study supports a strategy of using anti-tTG antibody concentrations to monitor newly diagnosed and established patients with coeliac disease, and to target dietetic intervention to reduce the risk of complication.
Author(s): Dipper CR, Maitra S, Thomas R, Lamb CA, McLean-Tooke APC, Ward R, Smith D, Spickett G, Mansfield JC
Publication type: Article
Publication status: Published
Journal: Alimentary Pharmacology and Therapeutics
Year: 2009
Volume: 30
Issue: 3
Pages: 236-244
ISSN (print): 0269-2813
ISSN (electronic): 1365-2036
Publisher: Wiley-Blackwell Publishing Ltd.
URL: http://dx.doi.org/10.1111/j.1365-2036.2009.04039.x
DOI: 10.1111/j.1365-2036.2009.04039.x
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