ArticleThe American journal of gastroenterology2015
Are ESPGHAN "biopsy-sparing" guidelines for celiac disease also suitable for asymptomatic patients?
Article in The American journal of gastroenterology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 65 citations in OpenAlex.
- Carbon Dioxide vs. Air Insufflation for Pediatric Gastrointestinal Endoscopy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Frontiers in pediatrics · 2021Pooled it
- One threshold does not fit all: assay-specific validation of anti-tTG IgA tests for biopsy-free diagnosis of pediatric celiac disease.Immunologic research · 2026Article
- The Frequency of Celiac Disease in Siblings of Celiac Patients and Applicability of Non-Biopsy Diagnostic Criteria.Journal of clinical medicine · 2026Article
- Challenges in the Pediatric Celiac Disease Diagnosis: An Up-to-Date Review.Diagnostics (Basel, Switzerland) · 2025Review
- Applicability of ESPGHAN Biopsy-Free Guidelines for Celiac Disease Diagnosis: Insights from Türkiye.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2025Article
- Intestinal Anti-Endomysium Antibodies Are a Useful Tool for Diagnosing Celiac Disease in Pediatric and Adult Patients.Nutrients · 2024Article
- Predictors of celiac disease in patients with type 1 diabetes and positive tissue transglutaminase immunoglobulin A.Journal of pediatric gastroenterology and nutrition · 2024Article
- The Role of Intestinal Microbiota in Celiac Disease and Further Therapeutic Perspectives.Life (Basel, Switzerland) · 2023Review
- The Screening of Celiac Serology in Pediatric Patients Diagnosed with Type 1 Diabetes Mellitus.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2023Article
- Value of biopsy in a cohort of children with high-titer celiac serologies: observation of dynamic policy differences between Europe and North America.BMC health services research · 2020Observational
- Non-Biopsy Serology-Based Diagnosis of Celiac Disease in Adults Is Accurate with Different Commercial Kits and Pre-Test Probabilities.Nutrients · 2020Article
- Fasting Neurotensin Levels in Pediatric Celiac Disease Compared with a Control Cohort.Gastroenterology research and practice · 2020Article
- Gut Microbiota in Celiac Disease: Is There Any Role for Probiotics?Frontiers in immunology · 2020Review
- Seroprevalence of Antitransglutaminase and Antiendomysium Antibodies in Adult Colombian Blood Bank Donors.Canadian journal of gastroenterology & hepatology · 2020Article
- Celiac Disease and the Microbiome.Nutrients · 2019Review
- Interpretation and implementation of the revised European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guidelines on pediatric celiac disease amongst consultant general pediatricians in Southwest of England.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2019Article
- Diagnosing Celiac Disease: Towards Wide-Scale Screening and Serology-Based Criteria?Gastroenterology research and practice · 2019Review
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- Diagnosis of Celiac Disease: Taking a Bite Out of the Controversy.Digestive diseases and sciences · 2018Review
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesIn 2012, European Society of Pediatric Gastroenterology, Hepatology, and Nutrition published novel guidelines on celiac disease (CD) diagnosis. Symptomatic children with serum anti-transglutaminase (anti-tTG) antibody levels ≥10 times upper limit of normal (ULN) could avoid duodenal biopsies after positive HLA test and serum anti-endomysial antibodies (EMAs). So far, both asymptomatic and symptomatic patients with anti-tTG titer <10 times ULN should undergo upper endoscopy with duodenal biopsies to confirm diagnosis. The aim of this study was to assess the accuracy of serological tests to diagnose CD in asymptomatic patients.
methodsWe retrospectively reviewed data of 286 patients (age range: 10 months to 17 years) with CD diagnosis based on elevated titer of anti-tTG, EMA positivity, and histology. All patients were distinguished between symptomatic and asymptomatic; histological lesions were graded according to the Marsh-Oberhuber (MO) criteria. Fisher exact test was applied to analyze both groups in terms of diagnostic reliability of serological markers.
resultsA total of 196 patients (68.53%) had anti-tTG titers ≥10 times ULN. Among them, a group of 156 patients (79.59%) also had symptoms suggestive of CD ("high-titer" symptomatic); of these, 142 patients (91.02%) showed severe lesion degree (3a, 3b, 3c MO). Conversely, 40 out of 196 patients (20.40%) were asymptomatic ("high-titer" asymptomatic) and 37 patients (92.5%) of them showed severe lesion degree (3a, 3b, 3c MO). No difference in histological damage was found between "high-titer" symptomatic and "high-titer" asymptomatic children (Fisher exact test, P=1.000).
conclusionsIf confirmed in large multicenter prospective studies, the "biopsy-sparing" protocol seems to be applicable to both symptomatic and asymptomatic patients with anti-tTG titer ≥10 times ULN, positive EMA, and HLA-DQ2/DQ8.
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