{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T19:00:29Z","timestamp":1783364429753,"version":"3.54.6"},"reference-count":17,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T00:00:00Z","timestamp":1727913600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Serologic diagnosis using tissue transglutaminase immunoglobulin A (TTG\u2010IgA) and endomysial antibody (EMA) is being integrated into the care of pediatric patients with positive screening for celiac disease. The purpose of this study was to assess the utility of EMA in pediatric patients being considered for serologic diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with TTG\u2010IgA testing performed between May 1, 2022 and April 30, 2023 and with subsequent duodenal biopsy within 6 months were included. TTG\u2010IgA serum samples were frozen and sent for EMA testing and titer. EMA was evaluated for positivity and TTG\u2010IgA (normal &lt;15\u2009U\/mL) for elevation &lt;10 times (10x) the upper limit of normal (ULN) and \u226510x ULN (\u2265150\u2009U\/mL). Sensitivity and specificity of EMA and TTG\u2010IgA were calculated using biopsy histology as the gold standard.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four hundred and eighty\u2010six patients were included. The sensitivity and specificity of TTG\u2010IgA \u226515\u2009U\/mL was 87.5% and 95.4% while EMA was 77.5% and 97.3%. For patients with TTG\u2010IgA \u226510x ULN the specificity was 99.3%. The positive predictive value of TTG\u2010IgA at \u226510x ULN was 91.4% and for EMA was 83.6%. All three patients with false\u2010positive TTG\u2010IgA \u226510x ULN also had false\u2010positive EMA, and two of these patients had type 1 diabetes mellitus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>TTG\u2010IgA has greater sensitivity at the screening threshold of \u226515\u2009U\/mL and greater specificity and positive predictive value at \u226510x ULN than EMA. TTG\u2010IgA at \u226510x ULN is superior to EMA for the serologic diagnosis of celiac disease.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jpn3.12382","type":"journal-article","created":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T07:48:59Z","timestamp":1727941739000},"page":"1164-1171","source":"Crossref","is-referenced-by-count":2,"title":["Tissue transglutaminase immunoglobulin A exceeds endomysial antibody in specificity of celiac diagnosis at \u226510 times the upper limit of normal"],"prefix":"10.1002","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9858-9719","authenticated-orcid":false,"given":"Maria Cristina","family":"Pacheco","sequence":"first","affiliation":[{"name":"Department of Laboratories Seattle Children's Hospital Seattle Washington USA"},{"name":"Department of Laboratory Medicine and Pathology University of Washington Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan L.","family":"Fink","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology University of Washington Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dale","family":"Lee","sequence":"additional","affiliation":[{"name":"Seattle Children's Hospital, Division of Gastroenterology and Hepatology Seattle Washington USA"},{"name":"Department of Pediatrics University of Washington Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Dickerson","sequence":"additional","affiliation":[{"name":"Department of Laboratories Seattle Children's Hospital Seattle Washington USA"},{"name":"Department of Laboratory Medicine and Pathology University of Washington Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,3]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e31821a23d0"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000002497"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000001216"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002075"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm0797-797"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.06.002"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.04.023"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/aqab104"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jim.2014.01.002"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0950-3528(95)90032-2"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-199910000-00019"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000001107"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2021.06.003"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.5223\/pghn.2021.24.2.218"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.11613\/BM.2020.020502"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1258\/acb.2009.009222"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2007.088344"}],"container-title":["Journal of Pediatric Gastroenterology and Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jpn3.12382","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T04:47:27Z","timestamp":1733287647000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jpn3.12382"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,3]]},"references-count":17,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1002\/jpn3.12382"],"URL":"https:\/\/doi.org\/10.1002\/jpn3.12382","archive":["Portico"],"relation":{},"ISSN":["0277-2116","1536-4801"],"issn-type":[{"value":"0277-2116","type":"print"},{"value":"1536-4801","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,3]]}}}