Transthyretin: A marker for celiac disease activity

Transthyretin (TTR), a well-established nutritional marker, was measured in patients with active and inactive celiac disease (CD) in order to assess its value as a marker of disease activity. CD activity was assessed by intestinal biopsy to determine intestinal atrophy histologically and by measuring the level of anti-endomysial antibody titer. TTR was measured in 26 CD patients fed a diet containing gluten and 22 CD patients fed a gluten- free diet. The control group was composed of 65 healthy sex- and age-matched children. We compared the TTR levels to the two established markers of CD activity. TTR levels were lowest among the celiac patients fed a diet containing gluten and differed significantly from those of the other two groups (r=0.7, p < 0.002). The TTR levels correlated inversely with both the degree of mucosal atrophy (r=0.6, p < 0.005) and with anti-endomysial antibody titers (p < 0.005). TTR levels appear to be correlated with morphologic and serologic markers of activity in celiac patients. TTR can be used as a systemic parameter in assessing celiac patients. It can contribute information to the evaluation of children in whom celiac disease is suspected, and it can monitor patients' diet compliance.