Ermarth et al identified factors that can help to diagnose celiac disease in a pediatric patient. The authors are from the University of Utah.
Patient selection: age <= 18 years
Predictive factors:
(1) serum tissue transglutaminase (TTG) IgA concentration as multiple of the upper limit of normal
(2) diabetes mellitus type I
(3) trisomy 21
A serum TTG IgA concentration > 6 times the ULN was 100% specific for celiac disease with a sensitivity of 50%. A concentration > 7 times the ULN precluded the need for small bowel biopsy, especially if a repeat serum level was also elevated.
A serum TTG IgA concentration >= 2.7 times the ULN had a positive predictive value of 89% (PPV 92% with age >= 8 years).
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