SEROLOGICAL DETECTION OF CELIAC DISEASE AMONG CHILDREN IN DIYALA PROVINCE- IRAQ

Background: celiac disease (CD) is an autoimmune disorder that is common in the general popula-tion. Early serological diagnosis of CD access to treatment and improves the patient's quality of life. Objectives: to explore the rate of CD among clinically suspected children in using serological tests and to assess the validity of these markers for thediagnosis of CD. Materials and methods: This case control study was conducted in Diyala province-Iraq during the period from September 2011 to April 2012 in Al-Batool Teaching Hospital for Maternity and Chil-dren. 156 children who were clinically suspected ashaving CD and 124 healthy children as control group were enrolled. The patient's age range was 1 month to 6 years and above. Information re-garding age, sex, residence, family history, and clinical signs were collected in a special question-naire. Commercially available serological kits for anti-gliadin IgA (AGA-IgA) and anti- tissue transglu-taminase IgA (anti-tTG-IgA) antibodies (Aeskulisa, Germany) were used by ELISA technique. Data were statistically analyzed and P value less than 0.05 was considered significant. Results: Based on the seropositivity of both anti-AGA IgA and anti-tTG IgA, 15 (9.6%) were consid-ered CD patients. whereas, patients who had either anti-AGA IgA (16.7%) or anti-tTG IgA (14.7%) positive were considered as symptomatic non-CD patients. The results showed that the anti-AGA IgA seropositivity was highly significant (P< 0.001) inCD patients compared to symptomatic non-CD pa-tients and control groups. Likewise, the anti-tTG IgA positivity was highly significant (P< 0.001) in CD patients compared to symptomatic non-CD patients and control groups. Both tests had similar sensi-tivity, but the anti-tTG IgA has higher specificity, accuracy, and positive predictive value. Conclusion: Serum Anti-tTG IgA is a good marker forthe diagnosis of CD among clinically suspected patients; however, for more accuracy both anti-tTG IgA and anti-AGA IgA can be used.