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🧪 What is Tissue Transglutaminase IgG (tTG-IgG)?

The tTG-IgG test measures IgG antibodies against tissue transglutaminase, an enzyme involved in the autoimmune process of celiac disease. This test is especially useful in patients with IgA deficiency where the tTG-IgA test may be falsely negative.

❓ Why is the Test Done?

To:

Screen for celiac disease in individuals who are IgA deficient
Diagnose celiac disease when tTG-IgA is inconclusive or negative but clinical suspicion remains high
Monitor disease activity and adherence to a gluten-free diet in special cases

📊 Normal Range

tTG-IgG Level	Interpretation
Negative or below cutoff	No evidence of celiac disease
Positive (above cutoff)	Suggestive of celiac disease

Cutoff values vary depending on assay and lab standards.

📈 Interpretation of Results

Result	Clinical Implications
Positive tTG-IgG	Suggestive of celiac disease, especially in IgA deficiency
Negative tTG-IgG	Celiac disease less likely, but clinical correlation needed

🧠 Associated Conditions

Condition	Details
Celiac disease	Autoimmune disorder triggered by gluten ingestion
IgA deficiency	Common immunodeficiency affecting antibody tests
Other autoimmune diseases	May coexist with celiac disease

🔄 Related / Follow-Up Tests

Total serum IgA – to check for IgA deficiency
tTG-IgA – primary screening test
Endomysial antibody (EMA) test – confirmatory
Small bowel biopsy – gold standard diagnosis
Genetic testing (HLA-DQ2/DQ8) – supportive diagnosis

✅ Fasting Required?

Test	Fasting Required
tTG-IgG	❌ No

📝 Summary Table

Parameter	Details
What	IgG antibodies against tissue transglutaminase enzyme
Why	Diagnose celiac disease in IgA deficient patients
Normal Range	Negative or below cutoff
Positive Result	Suggestive of celiac disease
Associated Conditions	Celiac disease, IgA deficiency
Follow-up Tests	Total IgA, tTG-IgA, EMA, biopsy
Fasting Required	❌ No

Tissue Transglutaminase IgG (TTG)

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