ArticleDigestive diseases and sciences2017
Application of the Biopsy-Sparing ESPGHAN Guidelines for Celiac Disease Diagnosis in Adults: A Real-Life Study.
Article in Digestive diseases and sciences, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Laboratory and Clinical Practices in the Study of Coeliac Disease in Children and Adults: Recommendations from a Spanish Multicentre Survey.Nutrients · 2025Article
- Non-biopsy Strategy for the Diagnosis of Celiac Disease in Adults: A Narrative Review.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2024Review
- Review
- More Than Three Years for Normalisation of Routine Laboratory Values after Gluten Withdrawal in Paediatric Coeliac Patients.Children (Basel, Switzerland) · 2023Article
- The correct methodological approach to the diagnosis of celiac disease: the point of view of the pathologist.Gastroenterology and hepatology from bed to bench · 2023Review
- Upper gastrointestinal endoscopic findings in celiac disease at diagnosis: A multicenter international retrospective study.World journal of gastroenterology · 2022Observational
- Article
- Is duodenal biopsy always necessary for the diagnosis of coeliac disease in adult patients with high anti-tissue transglutaminase (TTG) antibody titres?Frontline gastroenterology · 2022Article
- No-biopsy pathway following the interim BSG guidance reliably diagnoses adult coeliac disease.Frontline gastroenterology · 2022Article
- Serologic diagnosis of celiac disease: May it be suitable for adults?World journal of gastroenterology · 2021Review
- May Antitransglutaminase Levels Predict Severity of Duodenal Lesions in Adults with Celiac Disease?Medicina (Kaunas, Lithuania) · 2021Article
- Article
- Non-Biopsy Serology-Based Diagnosis of Celiac Disease in Adults Is Accurate with Different Commercial Kits and Pre-Test Probabilities.Nutrients · 2020Article
- The Role of Gastrointestinal-Related Fatty Acid-Binding Proteins as Biomarkers in Gastrointestinal Diseases.Digestive diseases and sciences · 2020Review
- Diagnosing Celiac Disease: Towards Wide-Scale Screening and Serology-Based Criteria?Gastroenterology research and practice · 2019Review
- Diagnosis of Celiac Disease: Taking a Bite Out of the Controversy.Digestive diseases and sciences · 2018Review
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7 authors.
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Abstract
backgroundCurrent adult celiac disease diagnosis requires histological confirmation. However, pediatric guidelines have proposed biopsy-sparing algorithms.
aimsTo explore the applicability of the ESPGHAN criteria and assess the accuracy of serology in predicting disease in adults.
methodsWe evaluated 234 consecutive adults showing elevated anti-tTG titers, EMA-positivity, and genetic susceptibility. Patients underwent upper endoscopy with duodenal biopsy. We determined optimal anti-tTG cutoff levels using ROC curves.
resultsMean anti-tTG levels were 71.1 ± 66.5 U/ml; mean normalized levels were 14.8 ± 14.1 × ULN (mean ± SD). Partial/total villous atrophy was present in 36%/55% of cases, respectively. Anti-tTG levels correlated with histology (r
conclusionIn adult symptomatic patients showing EMA-positivity and genetic susceptibility, anti-tTG titers correlated with histology. ESPGHAN criteria performed similarly to previous studies. However, a calculated 16 × ULN cutoff showed an improved PPV. Among prevalent assays, PPV peaked differently both after normalization and standardization, indicating intrinsic differences in performance, thus preventing uniform prediction of disease in a real-life setting. Assay-specific optimal cutoffs seem possible, but would complicate diagnostic criteria. However, biopsy-sparing strategies in adults could prove useful in challenging patients.
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