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Can Antibodies Spot Celiac Disease in Kids Without a Biopsy?


Scott Adams

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Scott Adams Grand Master
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Doctors diagnose celiac disease by confirming various clinical, genetic, serologic, and duodenal morphology features. Based on retrospective data, recent pediatric guidelines propose eliminating biopsy for patients with IgA-TTG levels more than 10-times the upper limit of normal (ULN), along with a few other criteria.

One retrospective study showed that researchers using levels of IgA-TTG and total IgA, or IgA-TTG and IgG against deamidated gliadin (IgG-DGL) could identify patients both with and without celiac disease. A team of researchers recently set out to validate the positive and negative predictive values (PPV and NPV) of these diagnostic procedures.

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    • trents
      So, I contacted Scott Adams, the author of that article and also the creator/admin of this website, and pointed out to him the need to clarify the information in the paragraph in question. He has now updated the paragraph and it is clear that the DGP-IGA does serve the purpose of circumventing the false negatives that IGA deficiencies can generate in the tTG-IGA antibody test.
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    • Kmd2024
      Hmm interesting I just assumed that any “IGA” tests including the DPG iga would be negative in a person who is IGA deficient but maybe that is not the case for the DPG test.
    • Scott Adams
      If you were just diagnosed I can say that if you go 100% gluten-free should should see dramatic improvement of your symptoms over the next few months, but the hard part is to stay gluten-free. This article has some detailed information on how to be 100% gluten-free, so it may be helpful (be sure to also read the comments section.):    
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