Anti-transglutaminase IgA antibodies (anti-tTG): screening for celiac disease | Clinique Omicron<\/title>\n<meta name=\"description\" content=\"Les anticorps anti-transglutaminase IgA (anti-tTG) sont le test s\u00e9rologique de r\u00e9f\u00e9rence pour d\u00e9pister la maladie c\u0153liaque. IgA totales d\u00e9ficit, biopsie duod\u00e9nale Marsh, r\u00e9gime sans gluten et suivi au Qu\u00e9bec.\">\n<meta name=\"keywords\" content=\"anti-transglutaminase IgA, anti-tTG maladie c\u0153liaque, d\u00e9pistage maladie c\u0153liaque, anticorps c\u0153liaque, anti-tTG interpr\u00e9tation, d\u00e9ficit IgA c\u0153liaque, maladie c\u0153liaque biopsie, r\u00e9gime sans gluten, anti-endomysium, maladie c\u0153liaque Qu\u00e9bec\">\n<link rel=\"preconnect\" href=\"https:\/\/fonts.googleapis.com\">\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap\" rel=\"stylesheet\">\n<style>\n@import url('https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap');\n\n.co-wrap * {\n font-family: 'Poppins', sans-serif;\n box-sizing: border-box;\n}\n.co-wrap {\n max-width: 1100px;\n margin: 0 auto;\n padding: 30px 0 60px;\n margin-top: 10px;\n}\n.co-label {\n font-family: 'Cinzel', serif;\n font-size: 14px;\n font-weight: bold;\n letter-spacing: 1px;\n text-transform: uppercase;\n color: #4D6577;\n margin-bottom: 14px;\n display: block;\n}\n.co-wrap h1 {\n font-size: 32px;\n font-weight: 500;\n color: #323C52;\n margin: 0 0 22px;\n line-height: 1.2;\n letter-spacing: 0.5px;\n}\n.co-intro {\n font-size: 16px;\n font-weight: 400;\n line-height: 1.75;\n color: #4D6577;\n margin-bottom: 36px;\n padding-bottom: 32px;\n border-bottom: 1px solid rgba(77,101,119,.2);\n}\n.co-wrap h2 {\n font-size: 20px;\n font-weight: 600;\n color: #323C52;\n margin: 32px 0 12px;\n letter-spacing: 0.3px;\n}\n.co-wrap p {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.7;\n margin-bottom: 14px;\n}\n.co-list {\n list-style: none;\n padding: 0;\n margin: 12px 0 24px;\n}\n.co-list li {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n padding: 10px 14px 10px 38px;\n margin-bottom: 8px;\n border-radius: 6px;\n position: relative;\n background: rgba(77,101,119,.06);\n border-left: 3px solid #4D6577;\n}\n.co-list li::before {\n content: \"\u2713\";\n position: absolute;\n left: 12px;\n font-weight: 700;\n color: #4D6577;\n}\n.co-table {\n width: 100%;\n border-collapse: collapse;\n margin: 14px 0 22px;\n font-size: 14px;\n border-radius: 8px;\n overflow: hidden;\n}\n.co-table thead tr {\n background: #323C52;\n color: #fff;\n}\n.co-table thead th {\n padding: 11px 16px;\n text-align: left;\n font-weight: 600;\n font-size: 13px;\n}\n.co-table tbody tr:nth-child(even) {\n background: rgba(77,101,119,.06);\n}\n.co-table tbody tr:nth-child(odd) {\n background: #fff;\n}\n.co-table td {\n padding: 10px 16px;\n color: #4D6577;\n border-bottom: 1px solid rgba(77,101,119,.12);\n font-size: 14px;\n vertical-align: top;\n}\n.co-table td:first-child {\n font-weight: 600;\n color: #323C52;\n}\n.co-infobox {\n display: flex;\n gap: 12px;\n background: rgba(77,101,119,.06);\n border-radius: 8px;\n border-left: 4px solid #4D6577;\n padding: 14px 18px;\n margin: 18px 0 28px;\n font-size: 14px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.65;\n}\n.co-infobox .ico {\n font-size: 18px;\n flex-shrink: 0;\n}\n.co-urgence {\n background: #fff8f8;\n border-left: 5px solid #c0392b;\n border-radius: 6px;\n padding: 20px 26px;\n margin: 24px 0 32px;\n}\n.co-urgence .co-urgence-titre {\n font-size: 13px;\n font-weight: 700;\n color: #c0392b;\n letter-spacing: 1.5px;\n text-transform: uppercase;\n margin-bottom: 10px;\n}\n.co-urgence p {\n color: #5a2020;\n font-size: 14px;\n margin: 0 0 10px;\n line-height: 1.7;\n}\n.co-urgence p:last-child {\n margin-bottom: 0;\n}\n.co-disclaimer {\n font-size: 13px;\n color: #8a9aaa;\n font-style: italic;\n border-top: 1px solid rgba(77,101,119,.15);\n padding-top: 24px;\n margin-top: 40px;\n line-height: 1.6;\n}\n<\/style>\n<\/head>\n<body>\n<div class=\"co-wrap\">\n\n <span class=\"co-label\">Gastroent\u00e9rologie & Biochimie clinique & M\u00e9decine de famille<\/span>\n <h1>Anti-transglutaminase IgA antibody (anti-tTG)<\/h1>\n\n <div class=\"co-intro\">\n Les anticorps anti-transglutaminase tissulaire de classe IgA (anti-tTG IgA) sont les auto-anticorps s\u00e9riques de r\u00e9f\u00e9rence pour le d\u00e9pistage et le suivi de la maladie c\u0153liaque \u2014 une ent\u00e9ropathie auto-immune chronique d\u00e9clench\u00e9e par l'ingestion de gluten (prot\u00e9ine de stockage du bl\u00e9 + seigle + orge) chez des individus g\u00e9n\u00e9tiquement pr\u00e9dispos\u00e9s (porteurs des all\u00e8les HLA-DQ2 et\/ou HLA-DQ8) \u2014 et constituent le test s\u00e9rologique recommand\u00e9 en premi\u00e8re ligne par les lignes directrices internationales (European Society for Paediatric Gastroenterology, Hepatology and Nutrition \u2014 ESPGHAN + American College of Gastroenterology \u2014 ACG + Soci\u00e9t\u00e9 canadienne de gastroent\u00e9rologie). La transglutaminase tissulaire de type 2 (tTG-2) est une enzyme exprim\u00e9e ubiquitairement dans les cellules intestinales qui d\u00e9amine les r\u00e9sidus de glutamine en acide glutamique dans les peptides de gliadine (sous-fraction du gluten) \u2192 transforme des peptides peu immunog\u00e8nes en peptides hautement immunog\u00e8nes \u2192 pr\u00e9sent\u00e9s par les cellules dendritiques aux lymphocytes T CD4+ via HLA-DQ2\/DQ8 \u2192 r\u00e9ponse immunitaire adaptative \u2192 inflammation chronique de la muqueuse duod\u00e9nale + j\u00e9junale \u2192 atrophie villositaire + hyperplasie des cryptes + augmentation des lymphocytes intra\u00e9pith\u00e9liaux (LIE) \u2192 syndrome de malabsorption. Les anti-tTG IgA ont une sensibilit\u00e9 de 90\u201398 % et une sp\u00e9cificit\u00e9 de 95\u201399 % pour la maladie c\u0153liaque active chez les patients ayant des IgA totales normales, ce qui en fait le test s\u00e9rologique le plus performant disponible. La r\u00e8gle capitale \u00e0 toujours respecter est de doser simultan\u00e9ment les IgA totales s\u00e9riques \u2014 car un d\u00e9ficit s\u00e9lectif en IgA (pr\u00e9valence 2\u20133 % dans la maladie c\u0153liaque vs 0,2\u20130,3 % en population g\u00e9n\u00e9rale) entra\u00eene un r\u00e9sultat faussement n\u00e9gatif des anti-tTG IgA + et n\u00e9cessite le dosage des anticorps de classe IgG (anti-tTG IgG + anti-DGP IgG \u2014 d\u00e9amidated gliadin peptides).\n <\/div>\n\n <h2>Tests s\u00e9rologiques disponibles pour la maladie c\u0153liaque<\/h2>\n\n <table class=\"co-table\">\n <thead>\n <tr>\n <th>Test<\/th>\n <th>Sensitivity<\/th>\n <th>Sp\u00e9cificit\u00e9<\/th>\n <th>Use<\/th>\n <\/tr>\n <\/thead>\n <tbody>\n <tr>\n <td>Anti-tTG IgA<\/td>\n <td>90\u201398 %<\/td>\n <td>95\u201399 %<\/td>\n <td>Test de d\u00e9pistage de premi\u00e8re ligne + suivi de l'observance au r\u00e9gime sans gluten \u2192 diminue avec l'\u00e9viction du gluten<\/td>\n <\/tr>\n <tr>\n <td>Anti-endomysium IgA (EMA IgA)<\/td>\n <td>85\u201398 %<\/td>\n <td>97\u2013100 %<\/td>\n <td>Tr\u00e8s haute sp\u00e9cificit\u00e9 \u2192 test confirmatoire si anti-tTG borderline + technique par immunofluorescence indirecte (plus laborieuse + op\u00e9rateur-d\u00e9pendante)<\/td>\n <\/tr>\n <tr>\n <td>Anti-DGP IgG (d\u00e9amidated gliadin peptides)<\/td>\n <td>80\u201390 %<\/td>\n <td>90\u201395 %<\/td>\n <td>Utilis\u00e9 si d\u00e9ficit s\u00e9lectif en IgA (IgA totales basses) + ou chez l'enfant < 2 ans (anti-tTG moins fiables avant 2 ans)<\/td>\n <\/tr>\n <tr>\n <td>Anti-tTG IgG<\/td>\n <td>70-80 %<\/td>\n <td>95\u201397 %<\/td>\n <td>Alternative si d\u00e9ficit en IgA + moins sensible que l'anti-DGP IgG<\/td>\n <\/tr>\n <tr>\n <td>Anti-gliadin IgA\/IgG (AGA)<\/td>\n <td>60-80 %<\/td>\n <td>80\u201390 %<\/td>\n <td>Tests anciens + peu sp\u00e9cifiques + abandonn\u00e9s dans la plupart des centres au profit des anti-DGP plus performants<\/td>\n <\/tr>\n <tr>\n <td>HLA-DQ2 \/ DQ8 (g\u00e9notypage)<\/td>\n <td>98\u201399 % (VPN)<\/td>\n <td>Faible (30\u201340 % population g\u00e9n\u00e9rale DQ2\/DQ8 positifs)<\/td>\n <td>Valeur pr\u00e9dictive N\u00c9GATIVE tr\u00e8s \u00e9lev\u00e9e \u2192 exclure la maladie c\u0153liaque si HLA-DQ2 et DQ8 n\u00e9gatifs + utile si patient d\u00e9j\u00e0 sous r\u00e9gime sans gluten (RSG) + ou r\u00e9sultats s\u00e9rologiques discordants<\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n\n <h2>Algorithme diagnostique de la maladie c\u0153liaque<\/h2>\n <ul class=\"co-list\">\n <li><strong>\u00c9tape 1 \u2014 S\u00e9rologie sur gluten (r\u00e9gime normal) :<\/strong> anti-tTG IgA + total serum IgA simultaneously + patient MUST consume gluten regularly at least 6-8 weeks before testing (at least 3 g\/day = 2 slices of bread\/day) \u2192 gluten-free diet already initiated falsely negative serology and histology<\/li>\n <li><strong>\u00c9tape 2 \u2014 Si d\u00e9ficit s\u00e9lectif en IgA (IgA totales < 0,07 g\/L) :<\/strong> substitute with anti-tTG IgG + anti-DGP IgG + anti-EMA IgG<\/li>\n <li><strong>\u00c9tape 3 \u2014 Si anti-tTG IgA positifs (ou IgG si d\u00e9ficit IgA) :<\/strong> gastroscopic duodenal biopsy (\u2265 4 duodenal biopsies + 1-2 duodenal bulb biopsies) \u2192 Marsh classification + mandatory histological confirmation criteria in adults<\/li>\n <li><strong>Exception p\u00e9diatrique (ESPGHAN 2020) :<\/strong> in children with anti-tTG IgA \u2265 10\u00d7 the upper limit of normal + EMA IgA positive on 2nd sample + HLA-DQ2 or DQ8 positive + compatible symptoms \u2192 diagnosis without biopsy (no-biopsy strategy) \u2192 avoids gastroscopy in children<\/li>\n <li><strong>\u00c9tape 4 \u2014 Biopsie duod\u00e9nale \u2014 Classification de Marsh-Oberhuber :<\/strong> Marsh 0 = normal + Marsh 1 = lymphocytes intra\u00e9pith\u00e9liaux (>25 LIE\/100 ent\u00e9rocytes) sans atrophie + Marsh 2 = LIE + hyperplasie des cryptes sans atrophie + Marsh 3a = atrophie villositaire partielle + Marsh 3b = atrophie villositaire subtotale + Marsh 3c = atrophie villositaire totale (aplatie compl\u00e8te) \u2192 Marsh \u2265 2 + contexte clinique + s\u00e9rologie = maladie c\u0153liaque<\/li>\n <li><strong>G\u00e9notypage HLA-DQ2\/DQ8 :<\/strong> if discordant results + or patient already on GFD + or strong clinical suspicion with negative serology \u2192 HLA-DQ2\/DQ8 negative = excludes celiac disease (VPN 99 %)<\/li>\n <\/ul>\n\n <h2>Indications du d\u00e9pistage<\/h2>\n <ul class=\"co-list\">\n <li><strong>Sympt\u00f4mes digestifs \u00e9vocateurs :<\/strong> chronic diarrhea + malabsorption + bloating + abdominal pain + steatorrhea + unexplained weight loss<\/li>\n <li><strong>Manifestations extra-digestives (maladie c\u0153liaque \u00absilencieuse\u00bb ou atypique) :<\/strong> refractory iron-deficiency anemia + or B12 + folate + zinc deficiency with no obvious cause + unexplained osteoporosis in young adults + infertility + repeated miscarriages + elevated transaminases with no identified cause + dermatitis herpetiformis (symmetrical pruritic papulovesicular rash on elbows + knees + buttocks = pathognomonic cutaneous manifestation of celiac disease) + peripheral neuropathy + gluten ataxia (unexplained cerebellar ataxia)<\/li>\n <li><strong>Maladies auto-immunes associ\u00e9es (risque \u00d7 3\u201310) :<\/strong> type 1 diabetes + Hashimoto's thyroiditis + Sj\u00f6gren's syndrome + systemic lupus erythematosus + autoimmune hepatitis<\/li>\n <li><strong>Maladies g\u00e9n\u00e9tiques associ\u00e9es :<\/strong> Down syndrome (trisomy 21 - prevalence celiac disease 5-12 %) + Turner syndrome + Williams syndrome<\/li>\n <li><strong>Ant\u00e9c\u00e9dents familiaux de maladie c\u0153liaque :<\/strong> risk of 10-15 % in 1st-degree relatives (parents + siblings + children)<\/li>\n <\/ul>\n\n <h2>Suivi de la maladie c\u0153liaque sous r\u00e9gime sans gluten<\/h2>\n <ul class=\"co-list\">\n <li><strong>Anti-tTG IgA as a follow-up biomarker :<\/strong> normalization of anti-tTG expected in 12-24 months under strict GFD + persistence of elevated anti-tTG after 12 months of GFD = gluten contamination or poor compliance (main cause) + or refractory celiac disease (rare)<\/li>\n <li><strong>Clinical and biological monitoring :<\/strong> CBC + ferritin + B12 + folates + vitamin D + calcium + liver function tests + TSH + bone densitometry (DEXA) if osteoporosis at diagnosis \u2192 annual reassessment + then every 2-3 years if stable<\/li>\n <li><strong>Consultation di\u00e9t\u00e9tique :<\/strong> essential for initiating GFD + for identifying hidden sources of gluten + dietary alternatives + preventing deficiencies<\/li>\n <li><strong>Biopsie de contr\u00f4le :<\/strong> systematically in adults at 12-24 months to confirm histological normalization under RSG + essential if persistent high anti-tTG levels<\/li>\n <\/ul>\n\n <div class=\"co-infobox\">\n <span class=\"ico\">\u2119\ufe0f<\/span>\n <span>Le d\u00e9pistage s\u00e9rologique de la maladie c\u0153liaque doit TOUJOURS \u00eatre r\u00e9alis\u00e9 sur un r\u00e9gime contenant du gluten \u2014 jamais apr\u00e8s que le patient ait d\u00e9j\u00e0 initi\u00e9 un r\u00e9gime sans gluten de lui-m\u00eame (ce qui est fr\u00e9quent en raison de la mode de l'alimentation sans gluten). Si le patient est d\u00e9j\u00e0 sous RSG, deux options existent : soit r\u00e9introduire le gluten pendant 6\u20138 semaines avant la s\u00e9rologie (gluten challenge), soit r\u00e9aliser le g\u00e9notypage HLA-DQ2\/DQ8 \u2014 si les deux all\u00e8les sont n\u00e9gatifs, la maladie c\u0153liaque est exclue sans avoir besoin de r\u00e9introduire le gluten.<\/span>\n <\/div>\n\n <div class=\"co-urgence\">\n <div class=\"co-urgence-titre\">Medical consultation recommended<\/div>\n <p>Consulter un m\u00e9decin pour un d\u00e9pistage de la maladie c\u0153liaque si une an\u00e9mie ferriprive r\u00e9cidivante sans cause \u00e9vidente + une diarrh\u00e9e chronique + un amaigrissement + une ost\u00e9oporose inexpliqu\u00e9e chez l'adulte jeune + ou une dermatite herp\u00e9tiforme sont pr\u00e9sents \u2014 ainsi que chez les patients atteints de diab\u00e8te de type 1 + de thyro\u00efdite de Hashimoto + ou ayant un parent au 1er degr\u00e9 avec une maladie c\u0153liaque confirm\u00e9e. Le d\u00e9pistage doit \u00eatre r\u00e9alis\u00e9 AVANT toute modification alimentaire. Pour le dosage des anti-tTG IgA + IgA totales + l'orientation vers la gastroent\u00e9rologie pour la biopsie duod\u00e9nale et la consultation di\u00e9t\u00e9tique, Clinique Omicron offre des consultations dans ses points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#c0392b;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n <\/div>\n\n <h2>Consult at Clinique Omicron<\/h2>\n <p>Les m\u00e9decins et infirmiers praticiens sp\u00e9cialis\u00e9s (IPS) de Clinique Omicron prescrivent le d\u00e9pistage s\u00e9rologique de la maladie c\u0153liaque (anti-tTG IgA + IgA totales) dans les populations \u00e0 risque et devant les pr\u00e9sentations atypiques (an\u00e9mie + ost\u00e9oporose + transaminases \u00e9lev\u00e9es + infertilit\u00e9), orientent vers la gastroent\u00e9rologie pour la biopsie duod\u00e9nale de confirmation, coordonnent la consultation di\u00e9t\u00e9tique pour l'initiation et le suivi du r\u00e9gime sans gluten, assurent la surveillance biologique annuelle (NFS + ferritine + vitamines + densitom\u00e9trie), et d\u00e9pistent les maladies auto-immunes associ\u00e9es (Hashimoto + diab\u00e8te de type 1). Des consultations sont disponibles dans plusieurs points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#4D6577;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n\n <p class=\"co-disclaimer\">Le contenu de cette page est fourni \u00e0 titre informatif uniquement et ne remplace pas l'avis d'un m\u00e9decin ou d'un gastroent\u00e9rologue. Le d\u00e9pistage s\u00e9rologique de la maladie c\u0153liaque doit toujours \u00eatre r\u00e9alis\u00e9 sous r\u00e9gime contenant du gluten \u2014 un r\u00e9sultat n\u00e9gatif sous r\u00e9gime sans gluten ne permet pas d'exclure le diagnostic. Les IgA totales doivent \u00eatre dos\u00e9es simultan\u00e9ment aux anti-tTG IgA pour d\u00e9tecter un d\u00e9ficit s\u00e9lectif en IgA.<\/p>\n\n<\/div>\n<\/body>\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Anticorps anti-transglutaminase IgA (anti-tTG) : d\u00e9pistage de la maladie c\u0153liaque | Clinique Omicron Gastroent\u00e9rologie & Biochimie clinique & M\u00e9decine de famille Anticorps anti-transglutaminase IgA (anti-tTG) Les anticorps anti-transglutaminase tissulaire de classe IgA (anti-tTG IgA) sont les auto-anticorps s\u00e9riques de r\u00e9f\u00e9rence pour le d\u00e9pistage et le suivi de la maladie c\u0153liaque \u2014 une ent\u00e9ropathie auto-immune chronique… <a href=\"https:\/\/cliniqueomicron.ca\/en\/transglutaminases-iga-anti-ttg\/\" rel=\"bookmark\">Read More \"<span class=\"screen-reader-text\">Anti-transglutaminase IgA antibodies (anti-tTG): screening for celiac disease | Clinique Omicron<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":100,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","_themeisle_gutenberg_block_has_review":false,"_metasync_otto_title":"Transglutaminases IgA (anti-tTG) | Brossard | Clinique Omicron","_metasync_otto_description":"Transglutaminases IgA (anti-tTG) Transglutaminases IgA (anti-tTG) est un test de laboratoire qui permet d'\u00e9valuer certains aspects de votre \u00e9tat de sant\u00e9. Ce...","_metasync_otto_keywords":"transglutaminases iga anti ttg, Clinique Omicron, clinique m\u00e9dicale Qu\u00e9bec, m\u00e9decin g\u00e9n\u00e9raliste Montr\u00e9al, Qu\u00e9bec","_metasync_otto_og_title":"","_metasync_otto_og_description":"Transglutaminases IgA (anti-tTG) Transglutaminases IgA (anti-tTG) est un test de laboratoire qui permet d'\u00e9valuer certains aspects de votre \u00e9tat de sant\u00e9. Ce...","_metasync_otto_twitter_title":"","_metasync_otto_twitter_description":"Transglutaminases IgA (anti-tTG) Transglutaminases IgA (anti-tTG) est un test de laboratoire qui permet d'\u00e9valuer certains aspects de votre \u00e9tat de sant\u00e9. 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La transglutaminase tissulaire de type 2 (tTG-2) est une enzyme exprim\u00e9e ubiquitairement dans les cellules intestinales qui d\u00e9amine les r\u00e9sidus de glutamine en acide glutamique dans les peptides de gliadine (sous-fraction du gluten) \u2192 transforme des peptides peu immunog\u00e8nes en peptides hautement immunog\u00e8nes \u2192 pr\u00e9sent\u00e9s par les cellules dendritiques aux lymphocytes T CD4+ via HLA-DQ2\/DQ8 \u2192 r\u00e9ponse immunitaire adaptative \u2192 inflammation chronique de la muqueuse duod\u00e9nale + j\u00e9junale \u2192 atrophie villositaire + hyperplasie des cryptes + augmentation des lymphocytes intra\u00e9pith\u00e9liaux (LIE) \u2192 syndrome de malabsorption. Les anti-tTG IgA ont une sensibilit\u00e9 de 90\u201398 % et une sp\u00e9cificit\u00e9 de 95\u201399 % pour la maladie c\u0153liaque active chez les patients ayant des IgA totales normales, ce qui en fait le test s\u00e9rologique le plus performant disponible. La r\u00e8gle capitale \u00e0 toujours respecter est de doser simultan\u00e9ment les IgA totales s\u00e9riques \u2014 car un d\u00e9ficit s\u00e9lectif en IgA (pr\u00e9valence 2\u20133 % dans la maladie c\u0153liaque vs 0,2\u20130,3 % en population g\u00e9n\u00e9rale) entra\u00eene un r\u00e9sultat faussement n\u00e9gatif des anti-tTG IgA + et n\u00e9cessite le dosage des anticorps de classe IgG (anti-tTG IgG + anti-DGP IgG \u2014 d\u00e9amidated gliadin peptides).\n <\/div>\n\n <h2>Tests s\u00e9rologiques disponibles pour la maladie c\u0153liaque<\/h2>\n\n <table class=\"co-table\">\n <thead>\n <tr>\n <th>Test<\/th>\n <th>Sensitivity<\/th>\n <th>Sp\u00e9cificit\u00e9<\/th>\n <th>Use<\/th>\n <\/tr>\n <\/thead>\n <tbody>\n <tr>\n <td>Anti-tTG IgA<\/td>\n <td>90\u201398 %<\/td>\n <td>95\u201399 %<\/td>\n <td>Test de d\u00e9pistage de premi\u00e8re ligne + suivi de l'observance au r\u00e9gime sans gluten \u2192 diminue avec l'\u00e9viction du gluten<\/td>\n <\/tr>\n <tr>\n <td>Anti-endomysium IgA (EMA IgA)<\/td>\n <td>85\u201398 %<\/td>\n <td>97\u2013100 %<\/td>\n <td>Tr\u00e8s haute sp\u00e9cificit\u00e9 \u2192 test confirmatoire si anti-tTG borderline + technique par immunofluorescence indirecte (plus laborieuse + op\u00e9rateur-d\u00e9pendante)<\/td>\n <\/tr>\n <tr>\n <td>Anti-DGP IgG (d\u00e9amidated gliadin peptides)<\/td>\n <td>80\u201390 %<\/td>\n <td>90\u201395 %<\/td>\n <td>Utilis\u00e9 si d\u00e9ficit s\u00e9lectif en IgA (IgA totales basses) + ou chez l'enfant < 2 ans (anti-tTG moins fiables avant 2 ans)<\/td>\n <\/tr>\n <tr>\n <td>Anti-tTG IgG<\/td>\n <td>70-80 %<\/td>\n <td>95\u201397 %<\/td>\n <td>Alternative si d\u00e9ficit en IgA + moins sensible que l'anti-DGP IgG<\/td>\n <\/tr>\n <tr>\n <td>Anti-gliadin IgA\/IgG (AGA)<\/td>\n <td>60-80 %<\/td>\n <td>80\u201390 %<\/td>\n <td>Tests anciens + peu sp\u00e9cifiques + abandonn\u00e9s dans la plupart des centres au profit des anti-DGP plus performants<\/td>\n <\/tr>\n <tr>\n <td>HLA-DQ2 \/ DQ8 (g\u00e9notypage)<\/td>\n <td>98\u201399 % (VPN)<\/td>\n <td>Faible (30\u201340 % population g\u00e9n\u00e9rale DQ2\/DQ8 positifs)<\/td>\n <td>Valeur pr\u00e9dictive N\u00c9GATIVE tr\u00e8s \u00e9lev\u00e9e \u2192 exclure la maladie c\u0153liaque si HLA-DQ2 et DQ8 n\u00e9gatifs + utile si patient d\u00e9j\u00e0 sous r\u00e9gime sans gluten (RSG) + ou r\u00e9sultats s\u00e9rologiques discordants<\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n\n <h2>Algorithme diagnostique de la maladie c\u0153liaque<\/h2>\n <ul class=\"co-list\">\n <li><strong>\u00c9tape 1 \u2014 S\u00e9rologie sur gluten (r\u00e9gime normal) :<\/strong> anti-tTG IgA + total serum IgA simultaneously + patient MUST consume gluten regularly at least 6-8 weeks before testing (at least 3 g\/day = 2 slices of bread\/day) \u2192 gluten-free diet already initiated falsely negative serology and histology<\/li>\n <li><strong>\u00c9tape 2 \u2014 Si d\u00e9ficit s\u00e9lectif en IgA (IgA totales < 0,07 g\/L) :<\/strong> substitute with anti-tTG IgG + anti-DGP IgG + anti-EMA IgG<\/li>\n <li><strong>\u00c9tape 3 \u2014 Si anti-tTG IgA positifs (ou IgG si d\u00e9ficit IgA) :<\/strong> gastroscopic duodenal biopsy (\u2265 4 duodenal biopsies + 1-2 duodenal bulb biopsies) \u2192 Marsh classification + mandatory histological confirmation criteria in adults<\/li>\n <li><strong>Exception p\u00e9diatrique (ESPGHAN 2020) :<\/strong> in children with anti-tTG IgA \u2265 10\u00d7 the upper limit of normal + EMA IgA positive on 2nd sample + HLA-DQ2 or DQ8 positive + compatible symptoms \u2192 diagnosis without biopsy (no-biopsy strategy) \u2192 avoids gastroscopy in children<\/li>\n <li><strong>\u00c9tape 4 \u2014 Biopsie duod\u00e9nale \u2014 Classification de Marsh-Oberhuber :<\/strong> Marsh 0 = normal + Marsh 1 = lymphocytes intra\u00e9pith\u00e9liaux (>25 LIE\/100 ent\u00e9rocytes) sans atrophie + Marsh 2 = LIE + hyperplasie des cryptes sans atrophie + Marsh 3a = atrophie villositaire partielle + Marsh 3b = atrophie villositaire subtotale + Marsh 3c = atrophie villositaire totale (aplatie compl\u00e8te) \u2192 Marsh \u2265 2 + contexte clinique + s\u00e9rologie = maladie c\u0153liaque<\/li>\n <li><strong>G\u00e9notypage HLA-DQ2\/DQ8 :<\/strong> if discordant results + or patient already on GFD + or strong clinical suspicion with negative serology \u2192 HLA-DQ2\/DQ8 negative = excludes celiac disease (VPN 99 %)<\/li>\n <\/ul>\n\n <h2>Indications du d\u00e9pistage<\/h2>\n <ul class=\"co-list\">\n <li><strong>Sympt\u00f4mes digestifs \u00e9vocateurs :<\/strong> chronic diarrhea + malabsorption + bloating + abdominal pain + steatorrhea + unexplained weight loss<\/li>\n <li><strong>Manifestations extra-digestives (maladie c\u0153liaque \u00absilencieuse\u00bb ou atypique) :<\/strong> refractory iron-deficiency anemia + or B12 + folate + zinc deficiency with no obvious cause + unexplained osteoporosis in young adults + infertility + repeated miscarriages + elevated transaminases with no identified cause + dermatitis herpetiformis (symmetrical pruritic papulovesicular rash on elbows + knees + buttocks = pathognomonic cutaneous manifestation of celiac disease) + peripheral neuropathy + gluten ataxia (unexplained cerebellar ataxia)<\/li>\n <li><strong>Maladies auto-immunes associ\u00e9es (risque \u00d7 3\u201310) :<\/strong> type 1 diabetes + Hashimoto's thyroiditis + Sj\u00f6gren's syndrome + systemic lupus erythematosus + autoimmune hepatitis<\/li>\n <li><strong>Maladies g\u00e9n\u00e9tiques associ\u00e9es :<\/strong> Down syndrome (trisomy 21 - prevalence celiac disease 5-12 %) + Turner syndrome + Williams syndrome<\/li>\n <li><strong>Ant\u00e9c\u00e9dents familiaux de maladie c\u0153liaque :<\/strong> risk of 10-15 % in 1st-degree relatives (parents + siblings + children)<\/li>\n <\/ul>\n\n <h2>Suivi de la maladie c\u0153liaque sous r\u00e9gime sans gluten<\/h2>\n <ul class=\"co-list\">\n <li><strong>Anti-tTG IgA as a follow-up biomarker :<\/strong> normalization of anti-tTG expected in 12-24 months under strict GFD + persistence of elevated anti-tTG after 12 months of GFD = gluten contamination or poor compliance (main cause) + or refractory celiac disease (rare)<\/li>\n <li><strong>Clinical and biological monitoring :<\/strong> CBC + ferritin + B12 + folates + vitamin D + calcium + liver function tests + TSH + bone densitometry (DEXA) if osteoporosis at diagnosis \u2192 annual reassessment + then every 2-3 years if stable<\/li>\n <li><strong>Consultation di\u00e9t\u00e9tique :<\/strong> essential for initiating GFD + for identifying hidden sources of gluten + dietary alternatives + preventing deficiencies<\/li>\n <li><strong>Biopsie de contr\u00f4le :<\/strong> systematically in adults at 12-24 months to confirm histological normalization under RSG + essential if persistent high anti-tTG levels<\/li>\n <\/ul>\n\n <div class=\"co-infobox\">\n <span class=\"ico\">\u2119\ufe0f<\/span>\n <span>Le d\u00e9pistage s\u00e9rologique de la maladie c\u0153liaque doit TOUJOURS \u00eatre r\u00e9alis\u00e9 sur un r\u00e9gime contenant du gluten \u2014 jamais apr\u00e8s que le patient ait d\u00e9j\u00e0 initi\u00e9 un r\u00e9gime sans gluten de lui-m\u00eame (ce qui est fr\u00e9quent en raison de la mode de l'alimentation sans gluten). Si le patient est d\u00e9j\u00e0 sous RSG, deux options existent : soit r\u00e9introduire le gluten pendant 6\u20138 semaines avant la s\u00e9rologie (gluten challenge), soit r\u00e9aliser le g\u00e9notypage HLA-DQ2\/DQ8 \u2014 si les deux all\u00e8les sont n\u00e9gatifs, la maladie c\u0153liaque est exclue sans avoir besoin de r\u00e9introduire le gluten.<\/span>\n <\/div>\n\n <div class=\"co-urgence\">\n <div class=\"co-urgence-titre\">Medical consultation recommended<\/div>\n <p>Consulter un m\u00e9decin pour un d\u00e9pistage de la maladie c\u0153liaque si une an\u00e9mie ferriprive r\u00e9cidivante sans cause \u00e9vidente + une diarrh\u00e9e chronique + un amaigrissement + une ost\u00e9oporose inexpliqu\u00e9e chez l'adulte jeune + ou une dermatite herp\u00e9tiforme sont pr\u00e9sents \u2014 ainsi que chez les patients atteints de diab\u00e8te de type 1 + de thyro\u00efdite de Hashimoto + ou ayant un parent au 1er degr\u00e9 avec une maladie c\u0153liaque confirm\u00e9e. Le d\u00e9pistage doit \u00eatre r\u00e9alis\u00e9 AVANT toute modification alimentaire. Pour le dosage des anti-tTG IgA + IgA totales + l'orientation vers la gastroent\u00e9rologie pour la biopsie duod\u00e9nale et la consultation di\u00e9t\u00e9tique, Clinique Omicron offre des consultations dans ses points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#c0392b;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n <\/div>\n\n <h2>Consult at Clinique Omicron<\/h2>\n <p>Les m\u00e9decins et infirmiers praticiens sp\u00e9cialis\u00e9s (IPS) de Clinique Omicron prescrivent le d\u00e9pistage s\u00e9rologique de la maladie c\u0153liaque (anti-tTG IgA + IgA totales) dans les populations \u00e0 risque et devant les pr\u00e9sentations atypiques (an\u00e9mie + ost\u00e9oporose + transaminases \u00e9lev\u00e9es + infertilit\u00e9), orientent vers la gastroent\u00e9rologie pour la biopsie duod\u00e9nale de confirmation, coordonnent la consultation di\u00e9t\u00e9tique pour l'initiation et le suivi du r\u00e9gime sans gluten, assurent la surveillance biologique annuelle (NFS + ferritine + vitamines + densitom\u00e9trie), et d\u00e9pistent les maladies auto-immunes associ\u00e9es (Hashimoto + diab\u00e8te de type 1). Des consultations sont disponibles dans plusieurs points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#4D6577;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n\n <p class=\"co-disclaimer\">Le contenu de cette page est fourni \u00e0 titre informatif uniquement et ne remplace pas l'avis d'un m\u00e9decin ou d'un gastroent\u00e9rologue. Le d\u00e9pistage s\u00e9rologique de la maladie c\u0153liaque doit toujours \u00eatre r\u00e9alis\u00e9 sous r\u00e9gime contenant du gluten \u2014 un r\u00e9sultat n\u00e9gatif sous r\u00e9gime sans gluten ne permet pas d'exclure le diagnostic. Les IgA totales doivent \u00eatre dos\u00e9es simultan\u00e9ment aux anti-tTG IgA pour d\u00e9tecter un d\u00e9ficit s\u00e9lectif en IgA.<\/p>\n\n<\/div>\n<\/body>\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Anticorps anti-transglutaminase IgA (anti-tTG) : d\u00e9pistage de la maladie c\u0153liaque | Clinique Omicron Gastroent\u00e9rologie & Biochimie clinique & M\u00e9decine de famille Anticorps anti-transglutaminase IgA (anti-tTG) Les anticorps anti-transglutaminase tissulaire de classe IgA (anti-tTG IgA) sont les auto-anticorps s\u00e9riques de r\u00e9f\u00e9rence pour le d\u00e9pistage et le suivi de la maladie c\u0153liaque \u2014 une ent\u00e9ropathie auto-immune chronique… <a href=\"https:\/\/cliniqueomicron.ca\/en\/transglutaminases-iga-anti-ttg\/\" rel=\"bookmark\">Read More \"<span class=\"screen-reader-text\">Anti-transglutaminase IgA antibodies (anti-tTG): screening for celiac disease | Clinique Omicron<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":100,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","_themeisle_gutenberg_block_has_review":false,"_metasync_otto_title":"Transglutaminases IgA (anti-tTG) | Brossard | Clinique Omicron","_metasync_otto_description":"Transglutaminases IgA (anti-tTG) Transglutaminases IgA (anti-tTG) est un test de laboratoire qui permet d'\u00e9valuer certains aspects de votre \u00e9tat de sant\u00e9. Ce...","_metasync_otto_keywords":"transglutaminases iga anti ttg, Clinique Omicron, clinique m\u00e9dicale Qu\u00e9bec, m\u00e9decin g\u00e9n\u00e9raliste Montr\u00e9al, Qu\u00e9bec","_metasync_otto_og_title":"","_metasync_otto_og_description":"Transglutaminases IgA (anti-tTG) Transglutaminases IgA (anti-tTG) est un test de laboratoire qui permet d'\u00e9valuer certains aspects de votre \u00e9tat de sant\u00e9. Ce...","_metasync_otto_twitter_title":"","_metasync_otto_twitter_description":"Transglutaminases IgA (anti-tTG) Transglutaminases IgA (anti-tTG) est un test de laboratoire qui permet d'\u00e9valuer certains aspects de votre \u00e9tat de sant\u00e9. Ce...","rank_math_title":"","rank_math_description":"","_yoast_wpseo_title":"","_yoast_wpseo_metadesc":"","_aioseo_title":"Anticorps anti-transglutaminase IgA (anti-tTG) : d\u00e9pistage de la maladie c\u0153liaque | Clinique Omicron","_aioseo_description":"Les anti-tTG IgA sont le test s\u00e9rologique de r\u00e9f\u00e9rence pour la maladie c\u0153liaque. IgA totales d\u00e9ficit IgG alternative, biopsie duod\u00e9nale Marsh atrophie villositaire, r\u00e9gime sans gluten normalisation 12-24 mois, HLA-DQ2 DQ8 exclusion au Qu\u00e9bec.","_metasync_seo_title":"","_metasync_seo_desc":"","_metasync_breadcrumb_title":"","_metasync_primary_category":0,"_metasync_primary_product_cat":0,"_metasync_otto_disabled":"","_metasync_hreflang":"","_metasync_plugin_sync_ts":"{\"aioseo\":\"2026-05-10T07:37:16+00:00\"}","_metasync_robots_advanced":"","footnotes":""},"class_list":["post-25023","page","type-page","status-publish","hentry"],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t<meta name=\"description\" content=\"Transglutaminases IgA (anti-tTG) Transglutaminases IgA (anti-tTG) est un test de laboratoire qui permet d'\u00e9valuer certains aspects de votre \u00e9tat de sant\u00e9. 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