Correlation between the Level of  Anti-Tissue Transglutinmase IgA and Marsh Classification  in  Celiac Disease

Al-Mosawi, Hadi

	Correlation between the Level of Anti-Tissue Transglutinmase IgA and Marsh Classification in Celiac Disease
Medical Journal of Babylon
Article 1, Volume 8, Issue 2, 2011, Pages 271-277
Author
Hadi Al-Mosawi
Abstract
Aim of study: evaluate the level Anti-tissue transglutinmase Anti body titer with the histopathological marsh classification in celiac disease patients Patients and materials: Fifty patients included in this study through the period between 2009-2010 All patients on gluen diet at the time of serum collection and histiopathological biopsy. all the patients included in this study above the age of 18 years . 44 patients present with G.I.T. symptoms 6 patients presented with non gastrointestinal symptoms oral endoscopic biopsy was taken from duodenum, The biopsy put in formalin fixation(10%), paraffin block and the slides was stained by (H&E), The Histopathological assessment for a celiac disease according to marsh classification, serum was collected and antitissue transglutinmase IgA Antibodies measured by ELIZA. Results: the histiopathological findings of second part duodenal biopsy as a following 8(16%) cases with Marsh I( intraepithelial lymphocytes infiltration), 10 (20%) cases with Marsh II (intraepithelial lymphocytes infiltration +crypt hyperplasia),16 (32%) cases Marsh IIIA (intraepithelial lymphocytes infiltration +crypt hyperplasia+ partial villous atrophy), 10 (20%) cases with Marsh IIIB (intraepithelial lymphocyte+crypt hyperplasia+ subtotal villous atrophy) 6 (12%) cases with Marsh IIIC(intraepithelial lymphocytes +crypt hyperplasia +total villous atrophy). Conclusion: In the present study the serum level of anti-tissue transglutinmase IgA anti body was higher in celiac with severe entropathy (Marsh IIIb-c) than in those with slight entropathy (Marsh I-IIIa), so the serological tests with high level>100 IU/ml reveal in celiac disease while low serological test need histophalogical assessment to avoid underestimate the real prevalence of celiac disease.

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