What is the Tissue Transglutaminase (TTG) antibody?

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Last updated: May 16, 2025View editorial policy

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From the Guidelines

TTG antibody, or tissue transglutaminase antibody, is a highly sensitive and specific blood test used to diagnose celiac disease, with a sensitivity of 93% and specificity of 98%, making it the preferred initial screening test 1.

Diagnosis and Testing

The test measures antibodies that the body produces against the enzyme tissue transglutaminase when a person with celiac disease consumes gluten.

  • For accurate results, patients should continue eating gluten-containing foods before testing, as eliminating gluten can lead to false negative results.
  • The test is typically ordered when someone shows symptoms like chronic diarrhea, abdominal pain, or unexplained weight loss, or has a family history of celiac disease.
  • A positive TTG antibody test usually requires confirmation with an intestinal biopsy for a definitive diagnosis.

Mechanism of Action

This test works because in celiac disease, the immune system mistakenly attacks the body's own tissue transglutaminase enzyme when gluten is present, creating these measurable antibodies.

Clinical Guidelines

Current guidelines recommend using TTG antibody as a first-line screening test for celiac disease, followed by intestinal biopsy for confirmation 1.

Key Points

  • TTG antibody is a highly sensitive and specific test for celiac disease.
  • Patients should continue eating gluten-containing foods before testing.
  • A positive test usually requires confirmation with an intestinal biopsy.
  • The test is an important tool for diagnosing celiac disease and improving patient outcomes.

From the Research

Definition and Purpose of TTG Antibody

  • TTG antibody, also known as tissue transglutaminase antibody, is a type of antibody that is commonly used as a marker for celiac disease 2, 3, 4, 5, 6.
  • The antibody is produced by the immune system in response to the presence of gluten in the diet, and its levels can be measured in the blood to diagnose and monitor celiac disease.

Measurement and Interpretation of TTG Antibody

  • The measurement of TTG antibody levels can be used to diagnose celiac disease, as well as to monitor the effectiveness of a gluten-free diet in patients with the condition 2, 3, 4, 6.
  • Elevated levels of TTG antibody can indicate the presence of celiac disease, while decreased levels can indicate a response to a gluten-free diet.
  • However, the interpretation of TTG antibody levels can be complex, and the results should be considered in conjunction with other diagnostic tests and clinical symptoms 2, 4, 6.

Clinical Significance of TTG Antibody

  • TTG antibody has been shown to be a sensitive and specific marker for celiac disease, and its measurement can be used to diagnose and monitor the condition 2, 3, 4, 5, 6.
  • Elevated levels of TTG antibody have been associated with an increased risk of complications, such as malnutrition and osteoporosis, in patients with celiac disease 6.
  • The measurement of TTG antibody levels can also be used to monitor the effectiveness of a gluten-free diet in patients with celiac disease, and to identify patients who may be at risk of complications 2, 3, 4, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

[Anti-transglutaminase antibody in adults with celiac disease and their relation to the presence and duration of gluten-free diet].

Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru, 2018

Research

Mild Duodenal Mucosal Injury and Increased Type I Interferon Signaling Are Preludes to Celiac Disease.

Laboratory investigation; a journal of technical methods and pathology, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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