Contemporary celiac disease diagnosis: is a biopsy avoidable?

Current Opinion in Gastroenterology
John R Mills, Joseph A Murray

Abstract

The duodenal biopsy is the gold standard for the diagnosis of celiac disease. However, given improvements in the performance of serological testing, the possibility of accurately diagnosing celiac disease without the need of a biopsy has attracted interest. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition has revised its recommendations to include a diagnostic algorithm that includes sequential serological testing and human leukocyte antigen genotyping for symptomatic children which would enable a diagnosis of celiac disease to be made in the absence of a confirmatory intestinal biopsy. Recent studies have evaluated the ESPGHAN guidelines and have mostly corroborated that celiac disease can be accurately diagnosed in specific pediatric patient populations without the need of a biopsy. However, two cautionary points have been raised that warrant further consideration - the success of this approach is highly dependent targeting a population with a high pretest probability of celiac disease, as well, the performance of serology assays must be established and the appropriate use of cutoffs is essential. The duodenal biopsy will remain the gold standard for diagnosing celiac disease in a majority of pat...Continue Reading

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Citations

Nov 15, 2017·Journal of Pediatric Gastroenterology and Nutrition·Magdalena ArayaFrancisco Pérez-Bravo
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Aug 30, 2019·Experimental and Molecular Pathology·Airton Pereira E SilvaGerlinde Agate Platais Brasil Teixeira

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Methods Mentioned

BETA
biopsy
biopsies

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