Oldenburger, I.B. (2017) The Value of Serum I-FABP in non-invasive diagnostics of celiac disease in patients with moderately elevated Ig-A anti-tTG levels. thesis, Medicine.
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Abstract
Background Current diagnostic guidelines for celiac disease (CD) still require a duodenal biopsy in patients with IgA anti-tissue transglutaminase levels (tTG) <10x the upper limit of normal (ULN). The search is on for markers that may enable a non-invasive diagnosis in this group of patients. Serum intestinal fatty acid binding protein (I-FABP), a marker for intestinal epithelial damage, may provide this. Aim Examine if I-FABP may provide a non-invasive diagnosis in patients with a tTG 1-10x ULN. Methods A total of 95 children with a clinical suspicion of CD and tTG 1-10x ULN were included. All underwent a duodenal biopsy within 3 months after their blood sample was taken. Serum I-FABP levels were determined retrospectively. As a control group served 161 children diagnosed with familial short stature or constitutional growth delay, all with normal tTG. Results Serum I-FABP in all 95 patients with a tTG 1-10x ULN (median 650 pg/ml) was significantly (P <0.0001) higher than in controls (median 263 pg/ml). I-FABP levels in the 71 patients with tTG 1-10x ULN with biopsy proven CD (median 725 pg/ml) were also significantly different (P<0.0001) from controls (median 263 pg/ml), but did not differ significantly (P=0.13) from levels in the 24 patients with a tTG 1-10x ULN but a normal biopsy (median 497 pg/ml). Analysis of the use of I-FABP in subgroups based on tTG levels resulted in no falsely diagnosed patients if tTG is 5-10x ULN and I-FABP≥ 880 pg/ml. Indeed, out of 24 patients with a tTG 5- 10x ULN all 11 patients with I-FABP ≥880 pg/ml had histologically proven CD. Analysis of patients with tTG <5x ULN did not provide any relevant cut-offs for I-FABP. Conclusion Addition of I-FABP to the diagnostic procedure of CD may provide a non-invasive diagnosis in part of the patients with a tTG 5-10x ULN.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor: and Verkade, Prof. Dr. H.J.Second supervisor: and Houwen, Prof. Dr. R.H.J. and Location: Pediatric Gastroenterology, Wilhelmina Children’s |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:04 |
| Last Modified: | 25 Jun 2020 11:04 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2397 |
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