Really? From what I understood from my (admittedly limited research) and from speaking to several gastroenterologists and dieticians, the biopsy is still the gold standard. The blood results can have false positives, as well negative results when in fact the patient has Coeliac disease. Also aren't there numerous other conditions that can cause the same markers in the blood as celiac disease? There are also certain blood test for celiac disease that aren't recommended becasue they give unreliable results if you have an IgA defficiancy.
Admittedly, if you get positive blood work and going gluten free helps, then chances are you have celiac disease, but saying "you do not need a biopsy for diagnostic purposes" is a bit of a dangerous statement isn't?
Any time you ask a GI doctor, they are going to respond that you need a biopsy for diagnosis. I think part of it is liability driven and the other part money. In some circumstances, a person might need to move on to a biopsy if their blood work was inconclusive and came back as a weak positive and then the biopsy can be used as a back up diagnosis, if you are lucky enough that they hit the right spot and find damage. I believe even a weak positive is indicative of Celiac but as you can see from reading this forum, some folks need more proof to convince them they have it and to stick to a strict gluten-free diet. I can understand that if they aren't that familiar with the disease or the diagnosis criteria. It is not always as clear cut as other diseases.
As far as I know, there are no other diseases that will elevate blood markers except the tTg. That can be elevated from other autoimmune diseases which are commonly seen with Celiac. However, the DGP and EMA will only be positive from Celiac Disease.
All of the IgA related testing in a Celiac panel will not be useful if a person has an IgA deficiency. They could have the IgG related tests done but may choose to have the biopsy if these are elevated because the EMA test is IgA based and that is usually the clincher in a blood panel for Celiac Disease.
Taking all this into account, I stand behind my sytatement that for many people, a biopsy is not required for diagnosis. Even Dr. Fasano, one of the leading researchers and Celiac physicians, has stated the same. Celiac testing is not a one size, fits all kind of thing. The bottom line for me is that if someone shows clear cut benefits from eating gluten free and regains their health, I stand behind them 100%. That is far better than having a negative biopsy and not going gluten free and becoming sicker and sicker.
I know relatives who had this happen and I am watching them suffer all because they believe a doctor unquestioningly.