More research supports biopsy-free celiac disease diagnosis

Emerging research supports non-biopsy diagnostic testing for celiac disease, according to a Dec. 14 report on

Newly published research in Gut supports diagnosing celiac disease after spotting a 10-fold increase in IgA antitissue transglutaminase antibody levels in combination with epithelial membrane antigen, or EMA, positivity.

Researchers studied three groups of patients: 740 patients were being seen at a celiac disease clinic in the United Kingdom, 532 patients were undergoing an upper gastrointestinal endoscopy in the U.K. after being suspected of having celiac disease, and 145 patients were being treated for raised tTG levels at multiple international sites.

All three groups of patients had elevated Iga tTG levels that resulted in small intestinal mucosal changes. Both are referred to as the hallmarks of clinical celiac disease.

"Our results show that IgA tTG titres of ≥10×ULN have a strong predictive value at identifying adults with intestinal changes diagnostic of CD," researchers concluded. "This study supports the use of a no-biopsy approach for the diagnosis of adult CD."

The research is the latest of several pieces that support moving away from a biopsy-based diagnosis. Biopsy screening was already eliminated for pediatric patients and recent guidelines from the European Society for the Study of Paediatric Gastroenterology and Hepatology and Nutrition recommend against the practice.

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