The comparison between endoscopic and pathologic results with the tissue transglutaminase antibody level of patients done endoscopy BY the pre diagnosis of celiac disease

Aim: The small intestine biopsy is the golden standard in the diagnosis of celiac disease. However, serological examination plays an important role for the diagnosis of celiac disease. A tissue transglutaminase IgA antibody is a specific high affinity indicator to diagnose celiac disease. The severity of villous atrophy increases with the rise of tissue transglutaminase IgA antibody level. The aim of this study is to compare the levels of tissue transglutaminase IgA antibody in the diagnosis of celiac disease with the findings of endoscopy and histopathologic, do diagnostic endoscopy in the patients by determining the level of significant tissue transglutaminase antibody in celiac disease and determine the antibody levels of patients who will be followed without doing endoscopy. Methods: The retrospective interviews were carried out in 211 cases admitted to Gaziantep University Medical Faculty Hospital Polyclinics of Paediatric Gastroenterology and Child Health Diseases between September 2018- March 2020, the levels of tissue transglutaminase antibody were checked owing to suspicion of celiac disease and gastroscopy was done. The gender, age, weight, height, complaint, presence of additional disease, the report of gastroscopy and histopathology, and laboratory results are recorded. The reference range of tissue transglutaminase IgA antibody level of patients: <20 RU/ml negative, > 20 RU/ ml positive and < 20 RU/ml first group, 20-50 RU/ml second group, 50-100 RU/ ml third group, 100-200 RU/ ml fourth group, > 200 RU/ml fifth group were determined. According to ESPGHAN standard, the diagnosis of celiac disease was regarded as significant for modified Marsh stage 2 and above. Gastroscopy results was classified as pathologic and normal in accordance with specific endoscopy results Findings: The cases were conducted with 123 (58,3%) female, 88 (41,7%) male. According to Marsh stages, 81 cases conform with stage 0 (38,4%), 9 cases conform with stage 1 (4,3% ), 28 cases conform with stage 3a (13,3 %), 33 cases conform with stage 3b (15,6%), 55 cases conform with stage 3c ( 26,1%). The tissue transglutaminase IgA level is above 200 in 103 of 121 cases which celiac disease was diagnosed. The positive statistically significant connection is between the tissue transglutaminase IgA level and Marsh stage Conclusions : The tissue transglutaminase antibody level increased more than 10 times in accordance with referance value, which correspond to 85.1 % of celiac disease and the group is suitable to do diagnostic endoscopy. However, the study has been limited owing to the low number of patients in other groups which have the tissue transglutaminase IgA level below 200. It has been obtained that complaints such as abdominal distention, iron deficiency anaemia, inappetence and short stature increase the risk of celiac disease in the celiac disease in the tissue transglutaminase IgA level of cases above 100. Thus, the complaints are important apart from serologic examinations for the endoscopy decision. Keywords: Celiac Disease, Tissue Transglutaminase IgA, Endoscopy, Marsh Stages, Antibody Level