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    Can Doctors Diagnose Celiac Disease in Kids Without Biopsy?


    Jefferson Adams

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


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    Photo: CC--AmblinA 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.

    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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    Guest Twin Mom

    Posted

    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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    Guest Linda

    Posted

    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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    Sources:
    1. Toft M, Dietrichs E. Aggravated stuttering following subthalamic deep brain stimulation in Parkinson’s disease--two cases. BMC Neurol. 2011 Apr 8;11:44.
    2. Tani T, Sakai Y. Stuttering after right cerebellar infarction: a case study. J Fluency Disord. 2010 Jun;35(2):141-5. Epub 2010 Mar 15.
    3. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    4. Jäncke L, Hänggi J, Steinmetz H. Morphological brain differences between adult stutterers and non-stutterers. BMC Neurol. 2004 Dec 10;4(1):23.
    5. Kell CA, Neumann K, von Kriegstein K, Posenenske C, von Gudenberg AW, Euler H, Giraud AL. How the brain repairs stuttering. Brain. 2009 Oct;132(Pt 10):2747-60. Epub 2009 Aug 26.
    6. Galantucci S, Tartaglia MC, Wilson SM, Henry ML, Filippi M, Agosta F, Dronkers NF, Henry RG, Ogar JM, Miller BL, Gorno-Tempini ML. White matter damage in primary progressive aphasias: a diffusion tensor tractography study. Brain. 2011 Jun 11.
    7. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    8. [No authors listed] Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 43-1988. A 52-year-old man with persistent watery diarrhea and aphasia. N Engl J Med. 1988 Oct 27;319(17):1139-48
    9. Molteni N, Bardella MT, Baldassarri AR, Bianchi PA. Celiac disease associated with epilepsy and intracranial calcifications: report of two patients. Am J Gastroenterol. 1988 Sep;83(9):992-4.
    10. http://ezinearticles.com/?Food-Allergy-and-Stuttering-Link&id=1235725 
    11. http://www.craig.copperleife.com/health/stuttering_allergies.htm 
    12. https://www.celiac.com/forums/topic/73362-any-help-is-appreciated/
    13. Ford RP. The gluten syndrome: a neurological disease. Med Hypotheses. 2009 Sep;73(3):438-40. Epub 2009 Apr 29.
    14. Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A. Does cryptic gluten sensitivity play a part in neurological illness? Lancet. 1996 Feb 10;347(8998):369-71.

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    Source:
    Alimentary Pharmacology & Therapeutics

    Jefferson Adams
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    Source:
    Gut. 2017 Feb;66(2):250-257. &nbsp;doi: 10.1136/gutjnl-2015-310148.