There are different practices amongst GIs on repeat biopsies vs. serology, and on gluten challenges. My sons g/i, for example, took the position that since my sons symptoms stopped on a gluten-free diet, and his previously sky-high EMA and ARA went back to normal, that it was unnecessary to do either a repeat biopsy or a gluten challenge. From the celiac list correspondence, I now see that my GI is rather liberal.**

Vijay Kumar, M.D., Research Associate Professor at the University of Buffalo and President and Director of IMMCO Diagnostics: I think your sons GI is doing the right thing. That is, if the EMA, ARA are normal (<1:2.5) and he is on a gluten free diet then there is no need to perform biopsy studies. The previous studies relating the EMA to biopsy studies tend to confirm this impression.

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