Elevated Serum Tissue Transglutaminase Antibodies in Children With Eosinophilic Esophagitis

Fevre, Anna K. Le; Walker, Marjorie M.; Hadji-Ashrafy, Amir; Bhatia, Rani; Mattes, Joërg; Talley, Nicholas J.; Nightingale, S. L.

doi:10.1097/mpg.0000000000001437

Cited by 5 publications

(7 citation statements)

References 38 publications

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“…Le Fevre et al 29 reported that tTG antibody was elevated in 23% of their EoE cohort, but elevated tTG antibody titres are not specific to CD. Although their study show any correlation between EoE and CD, they also recommended routine oesophageal and duodenal biopsies.…”

Section: Discussionmentioning

confidence: 95%

“…Although an association between CD and EoE has been reported in some studies, 8‐14 some researchers denied this relation 18‐20,29 . Hommeida et al 18 retrospectively reviewed 10.201 children who underwent endoscopic evaluation and found that the prevalence of EoE in children with CD was 1.83% when compared with 5.83% in all children who had EoE and stated that there was no increased risk of EoE in children with CD.…”

Section: Discussionmentioning

confidence: 99%

“…in some studies, 8-14 some researchers denied this relation. [18][19][20]29 Hommeida et al 18 retrospectively reviewed 10.201 children who underwent endoscopic evaluation and found that the prevalence of EoE in children with CD was 1.83% when compared with 5.83% in all children who had EoE and stated that there was no increased risk of EoE in children with CD. Lucendo et al 30 did not find an increased HLA DQ2 and DQ8 in those with EoE when compared with controls and they reviewed 197 references and concluded that currently available evidence does not support an association between EoE and CD.…”

Section: Although An Association Between CD and Eoe Has Been Reportedmentioning

confidence: 99%

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Association of celiac disease with eosophageal eosinophilia and eosinophilic eosophagitis

Urgancı

Usta

Civelek

2021

Int J Clinical Practice

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Background Aim of the study was to evaluate the association between celiac disease and eosinophilic oesophagitis/oesophageal eosinophilia in children. Methods A total of 278 patients with celiac disease (mean age: 7.12 ± 4.64 years, M/F: 0.77) were involved in the study. The patients were evaluated retrospectively in terms of clinical, endoscopic and histopathological findings. The association between celiac disease and eosinophilic oesophagitis/oesophageal eosinophilia was determined. Results According to Marsh classification system 6 (2.1%) of the patients were graded type 3A, 10 (3.5%) were type 3B, 262 (94.4%) were type 3C. The histopathological examination of oesophageal biopsy specimens of the patients revealed <15 eosinophils per high power field in only 4 (1.4%) patients. Two of these patients were positive for HLA DQ8, one was DQ2, and the other one was both DQ8 and DQ2. Tissue transglutaminase IgA level was above 300 U/mL in these patients. None of them had elevated serum total IgE levels, peripheral eosinophilia and history of atopic diseases. The gastrointestinal symptoms resolved and tissue transglutaminase IgA level of the patients were declined after 3 months of gluten‐free diet. Conclusion Although an association between celiac disease and eosinophilic oesophagitis/oesophageal eosinophilia have been postulated in recent years, no exact relationship was established in this study. This is the first study reporting the performance of follow‐up GI endoscopy with biopsies revealing the resolution of oesophageal eosinophilia.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Although An Association Between CD and Eoe Has Been Reportedmentioning

confidence: 99%

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Association of celiac disease with eosophageal eosinophilia and eosinophilic eosophagitis

Urgancı

Usta

Civelek

2021

Int J Clinical Practice

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“…Several studies have investigated and hypothesized potential causes of elevated tTG‐IgA in pediatric patients without CD, including increased polyclonal IgA production in children with juvenile idiopathic arthritis, an acute immunologic phenomenon in response to infectious disease, and in response to fibrogenesis and apoptosis in patients with end‐stage heart failure (25–28). Additionally, recent studies have reported elevated serum tTG‐IgA in non‐CD patients with EoE (29). The findings of this study support the aforementioned literature.…”

Section: Discussionmentioning

confidence: 99%

Repeat Biopsy to Assess Duodenal Healing in Children With Celiac Disease and Eosinophilic Gastrointestinal Disorders

et al. 2021

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The aim of the study was to determine the correlation between duodenal mucosal biopsies and tissue transglutaminase immunoglobulin A (tTG-IgA) levels in pediatric patients with biopsy-confirmed celiac disease (CD) and eosinophilic gastrointestinal disorders (EGID) who have had repeat duodenal biopsies after initiating a gluten-free diet. Methods: A retrospective chart review was performed of children with CD and EGID seen at the Children's Hospital of Philadelphia between 2003 and 2018. Data collected included duodenal biopsy pathology, celiac serology including tTG-IgA, and symptom reports. Duodenal healing was defined as normal villous architecture and no intraepithelial lymphocytes. These data were compared with tTG-IgA level. Data were analyzed with Fisher exact test and t test methods. Results: Thirty-nine patients had normal IgA and diagnoses of both CD and EGID. At second biopsy, 44% (17/39) of patients showed no histologic evidence of active CD and 36% (14/39) of patients had negative tTG-IgA values. Sixty percent (9/15) of patients with no evidence of CD on biopsy had abnormal tTG-IgA levels, and 57% (8/14) of patients with normal tTG-IgA levels had evidence of active disease on biopsy. Conclusions:The data show that an abnormal tTG-IgA drawn after initiation of a gluten-free diet is not correlated with duodenal mucosal injury in pediatric patients with CD and EGID. This suggests that serologic surveillance with tTG-IgA is not sufficient to monitor CD intestinal healing in this patient cohort. Persistent elevations of tTG-IgA in CD patients with normal duodenal biopsies should prompt investigation into other potential causes.

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“…How specific are elevations in TTG and DGP autoantibodies to celiac disease? Recently, Le Fevre et al have published findings on elevated TTG antibodies in almost a quarter of children with eosinophilic esophagitis ( Le Fevre et al, 2017 ). In addition, they review previous studies in which elevated serum TTG antibodies have been found in non-celiac disease states, including malnourished patients with cerebral palsy, alcohol consumers, and IBD and other autoimmune conditions.…”

mentioning

confidence: 99%

Tissue is the Issue: Duodenal Biopsies to Elucidate Gut Structure and Function Among Undernourished Children in Low-Resource Settings

Syed

Moore

2017

EBioMedicine

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Elevated Serum Tissue Transglutaminase Antibodies in Children With Eosinophilic Esophagitis

Cited by 5 publications

References 38 publications

Association of celiac disease with eosophageal eosinophilia and eosinophilic eosophagitis

Association of celiac disease with eosophageal eosinophilia and eosinophilic eosophagitis

Repeat Biopsy to Assess Duodenal Healing in Children With Celiac Disease and Eosinophilic Gastrointestinal Disorders

Tissue is the Issue: Duodenal Biopsies to Elucidate Gut Structure and Function Among Undernourished Children in Low-Resource Settings

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