{
  "abstract": "Objective: The 2020 European Society for Paediatric Gastroenterology, Hepatology and Nutrition no-biopsy algorithm for celiac disease (CD) requires a tissue transglutaminase IgA (tTG-IgA) level ≥10× the upper limit of normal (ULN) plus endomysial antibody IgA (EMA-IgA) positivity on a second sample. This study evaluated the diagnostic performance of the tTG-IgA ≥10× ULN threshold for predicting Marsh grade 3 histology at a center where EMA-IgA testing was not routinely available. Methods: This retrospective study included pediatric patients who underwent duodenal biopsy for suspected CD between January and December 2023 at Şanlıurfa Training and Research Hospital. Patients were categorized as tTG-IgA <10× ULN or ≥10× ULN. Sensitivity, specificity, predictive values, accuracy, and Cohen’s kappa were calculated using Marsh grade 3 as the reference standard. Factors associated with Marsh grade 3 were assessed using univariable logistic regression. Results: Of 141 patients, 108 (76.6%) had tTG-IgA ≥10× ULN and 130 (92.2%) had Marsh grade 3 histology. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for the threshold were 78.5%, 45.5%, 94.4%, 15.2%, and 75.9%, respectively. Agreement with Marsh grade 3 was low [κ=0.125; 95% confidence interval (CI), -0.040 to 0.290; p=0.072]. Any bulbar or distal duodenal endoscopic abnormality was associated with Marsh grade 3 (odds ratio =11.810; 95% CI, 2.697-51.703; p=0.001). Conclusion: At our institution, without routine EMA-IgA testing, tTG-IgA levels ≥10× ULN had high PPV for advanced histological injury; however, this marker alone was insufficient as a no-biopsy diagnostic criterion.",
  "abstract_shown": true,
  "affiliations": [
    "Şanlıurfa Training and Research Hospital, Clinic of Pediatric Gastroenterology, Şanlıurfa, Türkiye",
    "Şanlıurfa Training and Research Hospital, Clinic of Pathology, Şanlıurfa, Türkiye",
    "Harran University Faculty of Medicine, Department of Pediatrics, Şanlıurfa, Türkiye"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Demet TEKER DÜZTAŞ",
      "orcid": "0000-0003-3986-9523"
    },
    {
      "affs": [
        1
      ],
      "name": "Gizem AY HALDIZ",
      "orcid": "0000-0001-5654-6289"
    },
    {
      "affs": [
        2
      ],
      "name": "Aydın BOZKAYA",
      "orcid": "0000-0001-8800-2753"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6njcpqx7dk1zr.bib",
  "cited_by": 0,
  "doi": "10.4274/forbes.galenos.2026.22220",
  "fulltext_url": "https://forbestip.org/articles/association-between-tissue-transglutaminase-iga-levels-and-villous-atrophy-in-pediatric-celiac-disease-a-retrospective-cross-sectional-study/doi/forbes.galenos.2026.22220",
  "id": "6njcpqx7dk1zr",
  "issns": [
    "2757-5241"
  ],
  "landing_url": "https://doi.org/10.4274/forbes.galenos.2026.22220",
  "language": "en",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "R5-920"
    ],
    [
      "openalex",
      "2715|Celiac Disease Research and Management"
    ]
  ],
  "openalex": "W7224103220",
  "pdf_url": "https://forbestip.org/pdf/080b1dc9-b5e8-4382-b356-1411b16f2612/articles/forbes.galenos.2026.22220/192-200.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-28",
  "publisher": "BUCA SEYFI DEMIRSOY TRAINING AND RESEARCH HOSPITAL",
  "ris": "https://research.draconitic.com/paper/6njcpqx7dk1zr.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T14:22:06Z",
      "native_id": "0d1d70bb984940dc9580d61003d1a629",
      "source": "doaj",
      "url": "https://doi.org/10.4274/forbes.galenos.2026.22220"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2715|Celiac Disease Research and Management",
      "subfield": "general"
    }
  ],
  "title": "Association Between Tissue Transglutaminase IgA Levels and Villous Atrophy in Pediatric Celiac Disease: A Retrospective Cross-Sectional Study",
  "title_text": "Association Between Tissue Transglutaminase IgA Levels and Villous Atrophy in Pediatric Celiac Disease: A Retrospective Cross-Sectional Study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T14:22:06Z",
  "url": "https://research.draconitic.com/paper/6njcpqx7dk1zr",
  "venue": "Forbes Tıp Dergisi",
  "versions": []
}