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Mubarak A, Spierings E, Wolters VM, Otten HG, ten Kate FJ, Houwen RH. Children with celiac disease and high tTGA are genetically and phenotypically different. World J Gastroenterol 2013; 19(41): 7114-7120 [PMID: 24222955 DOI: 10.3748/wjg.v19.i41.7114]
World J Gastroenterol. Nov 7, 2013; 19(41): 7114-7120 Published online Nov 7, 2013. doi: 10.3748/wjg.v19.i41.7114
Children with celiac disease and high tTGA are genetically and phenotypically different
Amani Mubarak, Eric Spierings, Victorien M Wolters, Henny G Otten, Fiebo JW ten Kate, Roderick HJ Houwen
Amani Mubarak, Victorien M Wolters, Roderick HJ Houwen, Department of Pediatric Gastroenterology, University Medical Center Utrecht, Wilhelmina Children’s Hospital, 3508 AB Utrecht, The Netherlands
Eric Spierings, Henny G Otten, Department of Immunology, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands
Fiebo JW ten Kate, Department of Pathology, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands
Author contributions: Mubarak A designed research, performed research, analyzed data and wrote the paper; Spierings E and Otten HG contributed new reagents or analytic tools; Wolters VM and ten Kate FJW performed research; Houwen RHJ designed and supervised research, supervised the writing of the paper.
Correspondence to: Amani Mubarak, MD, Department of Pediatric Gastroenterology, University Medical Center Utrecht, Wilhelmina Children’s Hospital, PO BOX 85090, 3508 AB Utrecht, The Netherlands. a.mubarak@umcutrecht.nl
Telephone: +31-88-7555555 Fax: +31-88-7555347
Received: January 21, 2013 Revised: June 18, 2013 Accepted: July 4, 2013 Published online: November 7, 2013 Processing time: 299 Days and 11.3 Hours
Core Tip
Core tip: We prospectively investigated the differences between celiac disease (CD) (Marsh III) patients with tissue-transglutaminase antibody (tTGA) levels ≥ 100 U/mL and patients with lower tTGA levels. We found that patients with high tTGA more often carried multiple CD-associated heterodimers compared with patients with tTGA < 100 U/mL. In addition, high-tTGA patients have more advanced mucosal lesions that are also less patchy. Phenotypically, high-tTGA patients have a lower body weight and more often present with extraintestinal symptoms compared with patients with lower levels of tTGA, who more often have intestinal symptoms. These results provide further evidence that patients with tTGA ≥ 100 U/mL are truly a distinct group with more advanced disease.
