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  • Jefferson Adams

    No More Biopsies to Diagnose Celiac Disease in Children!

    Jefferson Adams
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    Reviewed and edited by a celiac disease expert.

      New guidelines recommend diagnosing children for celiac disease without using biopsies.


    Children can now avoid a scary biopsy procedure to get CD diagnosis. Image: CC BY-SA 2.0--teresachin2007
    Caption: Children can now avoid a scary biopsy procedure to get CD diagnosis. Image: CC BY-SA 2.0--teresachin2007

    Celiac.com 03/02/2020 - Current practice of using biopsy to diagnose children with celiac disease is changing to diagnosis without biopsy. 

    The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) recently issued new guidelines that recommend doctors diagnosing celiac disease omit biopsy in favor of a two-stage blood test, for the majority of children suspected of having the disease.



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    New guidelines for diagnosing celiac disease in children call for avoiding biopsies in favor of a two-stage blood test. Until now, about half of all kids diagnosed with celiac disease got a biopsy. The new guidelines mean that nearly all kids will avoid the procedure in favor of a two-stage blood test.

    The new guidelines recommend that doctors:

    • Conduct antibody screening in children with suspected celiac disease;
    • Diagnose symptomatic children without biopsy, using the same criteria as in patients with symptoms;
    • Invite parents and, where appropriate, children into any discussion about using biopsy;

    The new guidelines appear in the Journal of Pediatric Gastroenterology and Nutrition and call for clinicians diagnosing children with celiac disease to rely on accurate serology-based diagnosis without biopsy.

    Being able to diagnose children without biopsy is a major advance in celiac disease diagnosis, and will save millions of parents and children from what can be a costly, intimidating, and uncomfortable procedure that is not free of risk

    Read more at News-medical.net

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    Finally!! The data was clear for a long time that blood tests are very specific and sensitive. Subjecting children to a general anesthetic when the diagnosis was determined anyway by the blood tests is not only expensive but poses unnecessary risks. The concept that biopsy is the gold standard is just not true because even with a negative biopsy, if the blood tests are positive, the diagnosis is established. This is not how a gold standard works. 

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    I was recently diagnosed celiac disease by blood test last week. My biopsy last year showed that I wasn't. So no, biopsy is not a gold standard and can be wrong.

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    I was diagnosed with celiac almost 13 years ago. My blood test was off the charts, but I had to have an endoscopy to confirm it. I have relatives with type 1 diabetes, M.S., Hashimotos & IBS. Should they all get the blood test for celiac?

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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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