Celiac disease is an autoimmune enteropathy that occurs in genetically predisposed people following gluten consumption. In this study, we have evaluated the relationship between Anti t-TG level with Marsh system classification and clinical manifestations in patients with celiac disease.

This is a cross-sectional study by examining the information of clinical documents of 346 patients who were diagnosed with celiac disease during the years of 2010 to 2021 at Poursina Hakim Research institute in Isfahan that laboratory tests and biopsies of the first and second part of the duodenum were completed. In these patients, the relationship between Anti t-TG serological test, clinical manifestations and biopsy findings based on the Marsh classification system is evaluated. In patients with IgA deficiency, IgG anti t-TG serology is checked.

Among 346 patients (mean age = 26.53 ± 16.67 and 56.4% female), 55 patients (15.9%) were normal or grade 1, 31 patients (0.9%) were grade 2, 179 Patients (51.7%) were grade 3a or 3b and 81 patients (23.4%) were grade 3c or 4. The average of Anti t-TG serological test in the above groups were 70.94(±116.45), 146.56(±174.42), 149.08(±163.42) and 213.85 (±206.74) respectively; that is statistically significant in different stages. Among the 184 (53.2%) patients with atypical manifestations, 110 patients were in the 3a or 3b marsh group, while the typical symptoms of the disease are more common in the higher marsh group. Also, the level of Anti t-TG is higher in patients with typical clinical manifestations or those with diarrhea or arthralgia.

Higher anti t-TG levels as well as typical clinical manifestations and symptoms such as diarrhea and borborygemia are related to the severity of tissue damage in celiac disease