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  • Jefferson Adams

    Can Doctors Diagnose Celiac Disease in Kids Without Biopsy?

    Jefferson Adams
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    Reviewed and edited by a celiac disease expert.

    Photo: CC--Amblin
    Caption: Photo: CC--Amblin

    Celiac.com 03/09/2016 - Can doctors reliably diagnose celiac disease in kids without duodenal biopsy?

    A team of researchers recently set out to see if they could use predictive values of transglutaminase (tTG) antibodies to diagnose celiac disease in kids, without performing duodenal biopsy.



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    The research team included MA Aldaghi, SM Dehghani, and M Haghighat, of the Department of Pediatrics at Shiraz University of Medical Sciences in Shiraz, Iran.

    For their study, the team selected patients with likely celiac disease, who had been referred to a gastrointestinal clinic. The team first conducted physical examinations of the patients and performed tissue transglutaminase-immunoglobulin A (tTG-IgA) tests. For patients with serological titers higher than 18 IU/mL, the team performed upper endoscopy.

    The team assessed a total of 121 children, 69 female and 52 male, averaging 8.4 years of age. They found a significant association between blood tests and biopsy results; in other words, subjects with high antibody levels had more positive pathologic results for celiac disease, compared to others (P < 0.001).

    They achieved maximum sensitivity and maximum specificity of about 65% with a serological titer of 81.95 IU/ml. The calculated accuracy was lower in comparison with other studies.

    The team found lower antibody levels in patients with failure to gain weight and higher antibody levels in diabetic patients.

    In this study, a single blood test (tTg-IgA test) was not sufficient for researchers to reliably diagnose celiac disease without duodenal biopsy.

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    I have blood and biopsy diagnosed celiac and my son stopped growing at age 2, along with GI issues and behavioral issues. His blood test was negative, a later genetic test showed he carries the DQ8 gene, no one biopsied him but I took him gluten free at age 4 anyway. He began rapidly growing within a few weeks and his GI and behavioral issues vanished in a couple of days. His twin sister had no issues before and no change after the entire family went gluten-free. I personally think more research needs to be done for children's blood tests to be considered accurate. Thankful someone is looking into it.

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    In our family, we know lots of us have been diagnosed with celiac, so we just keep our babies off gluten, and all of us go gluten free. We don't need a diagnosis. And when we first found our mother had celiac, we didn't go getting a bunch of medical tests. We just started being real careful to stay away from gluten and learn all about it... if we felt better after a year or so, we continued to stay off it... I don't think most of this testing is even needed.

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  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,500 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.


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