Celiac Titers and Likelihood of Celiac Disease

A recent study (A Ermarth et al. Clin Gastroenterol Hepato 2017; 15: 396-402) retrospectively examined serology from 3555 pediatric patients who had intestinal biopsies, including 517 with celiac disease from a total of 30,413 with serologic testing These patients had their testing at a commercial lab (ARUP laboratiories). The authors note their regional prevalence of celiac disease was 1.7% of screened patients.

Table 1 lists the PPV, NPV, Sens, Spec based on the degree of elevation of the TTG IgA value.

Some examples:

  • If TTG IgA at 1-fold ULN, then PPV 61%, NPV 98%, Sens 90%, Spec 90%
  • If TTG IgA at 2-fold ULN, then PPV 79%, NPV 97%, Sens 82%, Spec 96%
  • If TTG IgA at 5-fold ULN, then PPV 93%, NPV 94%, Sens 62%, Spec 99%
  • If TTG IgA at 7-fold ULN, then PPV 96%, NPV 91%, Sens 41%, Spec 100%

Related blog links:

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