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No-biopsy diagnosis of CD an option in ‘carefully selected’ adult patients


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Journal
Gut
Reuters Health - 25/11/2020 - No-biopsy diagnosis of celiac disease (CD) is possible in both adults and children, although the sensitivity is low, new findings suggest. Across three adult cohorts, nearly everyone with IgA antitissue transglutaminase (tTG) antibody levels at least 10-fold higher than the upper limit of normal (ULN) had injuries to the small intestine characteristic of CD, Dr. David S. Sanders of Royal Hallamshire Hospital in Sheffield, U.K., and colleagues report in Gut. "This is a paradigm shift in the diagnosis of patients with celiac disease," Dr. Sanders told Reuters Health by phone. "We think it will reduce the number of endoscopies by about 25% for this group of patients, maybe more." According to guidelines from the European Society for the Study of Paediatric Gastroenterology, Hepatology and Nutrition, an IgA tTG titer higher than 10 times the ULN and a positive test for antiendomysial IgA antibodies (EMA) are adequate to support a CD ...


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