Antibody Concentrations Decrease 14-Fold in Children With Celiac Disease on a Gluten-Free Diet but Remain High at 3 Months
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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 GFD 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…
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A significant reduction in levels of IgA against tissue-transglutaminase (TGA) is already seen after three months of gluten-free diet if measured with the same assay.
“A significant reduction in levels of IgA against tissue-transglutaminase (TGA) is already seen after three months of GFD if measured with the same assay.”
From ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease. (2022) · cites this paper as [24]
After 3 months on gluten-free diet, TGA levels remained above 1x the upper level of normal (ULN) in 83.8% and above 10xULN in 26.6% of studied children.
“However, TGA levels remained above 1x the upper level of normal (ULN) in 83.8% and above 10xULN in 26.6% of studied children after 3 months on GFD (24).”
From ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease. (2022) · cites this paper as [24]
Cites
Lebwohl, B., Sanders, D. S., & Green, P. H. R. (2018) · The Lancet · doi:10.1016/s0140-6736(17)31796-8 · Cited by 1,065 · see citing works
Vécsei, E., Steinwendner, S., Kogler, H., Innerhofer, A., Hammer, K., Haas, O. A., Amann, G., Chott, A., Vogelsang, H., Schoenlechner, R., et al. (2014) · BMC Gastroenterology · doi:10.1186/1471-230x-14-28 · Cited by 41 · see citing works
Antitissue Transglutaminase Normalization Postdiagnosis in Children With Celiac Disease
Isaac, D. M., Rajani, S., Yaskina, M., Huynh, H. Q., & Turner, J. M. (2017) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0000000000001480 · Cited by 33 · see citing works
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ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease.
Mearin, M. L., Agardh, D., Antunes, H., Al‐toma, A., Auricchio, R., Castillejo, G., Catassi, C., Ciacci, C., Discepolo, V., Dolinsek, J., et al. (2022) · Journal of pediatric gastroenterology and nutrition · doi:10.1097/mpg.0000000000003540 · Cited by 186 · see citing works
- Authors
- Petroff, D., Wolf, J., Richter, T., Auth, M. K. H., Uhlig, H. H., Laass, M. W., Lauenstein, P., Krahl, A., Händel, N., de Laffolie, J., Hauer, A. C., Heiduk, M., Flemming, G., Schmidt, A., Hasenclever, D., & Mothes, T.
- Affiliations
- Leipzig University (DE)
- University Hospital Leipzig (DE)
- Klinikum St. Georg (DE)
- National Health Service (GB)
- John Radcliffe Hospital (GB)
- Technische Universität Dresden (DE)
- Deutsche Klinik für Diagnostik (DE)
- Klinikum Darmstadt (DE)
- Graz University Hospital (AT)
- Helios Vogtland Klinikum Plauen (DE)
- Medizinische Hochschule Hannover (DE)
- University Hospital in Halle (DE)
- Corresponding author
- Petroff, David
- ORCID
- Venue
- Clinical Gastroenterology and Hepatology
- Publisher
- Elsevier BV
- Published
- 2018-09
- Volume
- 16
- Issue
- 9
- Pages
- 1442-1449.e5
- ISSN
- 1542-3565 (ISSN-L)
- OpenAlex
- W2796879440
- Cited by
- 17
- References
- 3
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2023: 3 · 2022: 4 · 2020: 2
- FWCI
- 0.48
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Clinical Gastroenterology and Hepatology (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
- Health Sciences › Medicine › Surgery › Eosinophilic Esophagitis
- Life Sciences › Agricultural and Biological Sciences › Plant Science › Wheat and Barley Genetics and Pathology
- Keywords
- celiac disease, pediatric celiac disease, gluten-free diet, dietary adherence, serological response, duodenal biopsy
- MeSH terms
- Adolescent, Autoantibodies, Blood Chemical Analysis, Celiac Disease, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Immunoglobulin A, Infant, Male, Prospective Studies, Time Factors, Diet, Gluten-Free
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