Serum intestinal fatty acid–binding protein in the noninvasive diagnosis of celiac disease |
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| Authors: | Irene B. Oldenburger Victorien M. Wolters Tineke Kardol‐Hoefnagel Roderick H. J. Houwen Henny G. Otten |
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| Affiliation: | 1. Department of Pediatric Gastroenterology, Wilhelmina Children's Hospital, Utrecht, The Netherlands;2. Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands |
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| Abstract: | Current diagnostic guidelines for celiac disease (CD) in pediatric patients require a duodenal biopsy if the IgA anti‐tissue transglutaminase (tTG) is below 10x the upper limit of normal (ULN). Additional markers may enable a noninvasive diagnosis in this group. Serum intestinal‐fatty acid‐binding protein (I‐FABP), a marker for intestinal epithelial damage, could be useful in this respect. A total of 95 children with a clinical suspicion of CD and tTG 1‐10x ULN were investigated. All had a duodenal biopsy and analysis of serum I‐FABP. A control group of 161 children with familial short stature and normal tTG was included. I‐FABP levels in the 71 patients with tTG 1‐10x ULN and biopsy‐proven CD (median 725 pg/mL) were not significantly different (p = 0.13) from the levels in the 24 patients with a tTG 1‐10x ULN but a normal biopsy (median 497 pg/mL). However, when combining tTG and I‐FABP levels, 11/24 patients could have been diagnosed noninvasively if tTG is ≥ 50 U/mL and I‐FABP ≥880 pg/mL or in 12/19 patients if tTG is ≥ 60 U/mL and I‐FABP ≥ 620 pg/mL. Therefore, addition of I‐FABP to the diagnostic procedure of CD may provide a noninvasive diagnosis in patients with a tTG ≥ 50 U/mL. |
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| Keywords: | Celiac disease I‐FABP noninvasive diagnosis |
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