Abstract
Purpose of review 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 findings 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. Summary The duodenal biopsy will remain the gold standard for diagnosing celiac disease in a majority of patients. However, as serology assays evolve and as a greater understanding of the genetic risk factors of celiac disease is achieved, more patients may be accurately diagnosed without the need for a biopsy.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 80-85 |
| Number of pages | 6 |
| Journal | Current Opinion in Gastroenterology |
| Volume | 32 |
| Issue number | 2 |
| DOIs | |
| State | Published - Mar 1 2016 |
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Keywords
- celiac disease
- human leukocyte antigen
- intestinal biopsy
- serology
ASJC Scopus subject areas
- Gastroenterology
Cite this
Contemporary celiac disease diagnosis : Is a biopsy avoidable? / Mills, John R.; Murray, Joseph A.
In: Current Opinion in Gastroenterology, Vol. 32, No. 2, 01.03.2016, p. 80-85.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Contemporary celiac disease diagnosis
T2 - Is a biopsy avoidable?
AU - Mills, John R.
AU - Murray, Joseph A
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Purpose of review 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 findings 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. Summary The duodenal biopsy will remain the gold standard for diagnosing celiac disease in a majority of patients. However, as serology assays evolve and as a greater understanding of the genetic risk factors of celiac disease is achieved, more patients may be accurately diagnosed without the need for a biopsy.
AB - Purpose of review 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 findings 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. Summary The duodenal biopsy will remain the gold standard for diagnosing celiac disease in a majority of patients. However, as serology assays evolve and as a greater understanding of the genetic risk factors of celiac disease is achieved, more patients may be accurately diagnosed without the need for a biopsy.
KW - celiac disease
KW - human leukocyte antigen
KW - intestinal biopsy
KW - serology
UR - http://www.scopus.com/inward/record.url?scp=84956945054&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84956945054&partnerID=8YFLogxK
U2 - 10.1097/MOG.0000000000000245
DO - 10.1097/MOG.0000000000000245
M3 - Review article
C2 - 26784474
AN - SCOPUS:84956945054
VL - 32
SP - 80
EP - 85
JO - Current Opinion in Gastroenterology
JF - Current Opinion in Gastroenterology
SN - 0267-1379
IS - 2
ER -