Celiac.com 05/25/2011 - Perhaps because celiac disease presents clinically in such a variety of ways, diagnosing it often takes an inordinately long time. A serological test positive for antibodies against tissue transglutaminase is considered a very strong diagnostic indicator, and a duodenal biopsy revealing villous atrophy is still considered by many to be the diagnostic gold standard. But this idea is being questioned; some think the biopsy is unnecessary in the face of clear serological tests and symptoms, and that patients should be spared it; others claim that the onset of celiac disease can predate the occurrence of villous atrophy, yielding a falsely negative misinterpretation of biopsy results.

To lend some clarity, a group of researchers in Romania analyzed the significance of genetic tests. It has been estimated that 98% of people with celiac disease have the DQ2 and DQ8