Utilidad diagnóstica de los anticuerpos antitransglutaminasa tisular en niños con síntomas digestivos crónicos y sospecha de celiaquía

Introduction: Celiac disease is the most common chronic enteropathy in the world, but its occurrence in children with chronic gastrointestinal symptoms in our environment is unknown. Objective: To evaluate the diagnostic utility of anti-tissue transglutaminase antibodies in children with chronic digestive symptoms. Methods: A prospective study was carried out from January 2008 to April 2011 at the José Luis Miranda Pediatric University Hospital in Santa Clara. It included 535 infants in which anti-tissue transglutaminase antibodies was screened. Duodenal transendoscopic biopsies were taken, which were interpreted according to the Marsh-Oberhuber classification and were related to the serological test. The diagnostic efficacy of the antibodies was assessed and the frequency of celiac disease was estimated. Results: Only 11 patients were positive for antibody determination (2.1%). The predominant type of anatomo-pathologic lesion in patients who were positive for antibodies was typical of celiac disease (9 boys, 75%). There was an agreement between the serological and histopathological diagnosis of the duodenum (K=0.78, p<0.001). The frequency of celiac disease in the series was 2.2% (12 patients). The sensitivity and specificity of the antibodies was 75% and 99% respectively. Conclusions: There was a low frequency of celiac disease in the series, and a good diagnostic accuracy of the serological tests in children suspected of suffering the disease was achieved.Introducción: la enfermedad celíaca es la enteropatía crónica más frecuente en el mundo, pero se desconoce su ocurrencia en niños con síntomas digestivos crónicos en nuestro medio. Objetivo: evaluar la utilidad diagnóstica de los anticuerpos antitransglutaminasa tisular en niños con síntomas digestivos crónicos. Métodos: investigación prospectiva entre enero de 2008 y abril de 2011 en el Hospital Pediátrico Universitario “José Luis Miranda” de Santa Clara que incluyó 535 infantes en los que se pesquisaron anticuerpos antitransglutaminasa tisular, se tomaron biopsias transendoscópicas del duodeno que se interpretaron según la clasificación de Marsh-Oberhuber y se relacionaron con la prueba serológica, se evaluó la eficacia diagnóstica de los anticuerpos y se estimó la frecuencia de celiaquía. Resultados: solo 11 pacientes resultaron positivos a la determinación de anticuerpos (2.1%), el tipo de lesión anatomopatológica predominante en los pacientes positivos para los anticuerpos fue característico de la enfermedad celíaca -nueve niños (75%)-, se comprobó la concordancia entre los diagnósticos serológicos e histopatológicos del duodeno (K=0.78; p