Evidence map›Paper›PMID 40181591›Full record

ArticleAlimentary pharmacology & therapeutics2025

Biopsy-Sparing Diagnosis of Coeliac Disease Based on Endomysial Antibody Testing and Clinical Risk Assessment.

Stiliano Maimaris, Annalisa Schiepatti, Daniel Ignacio Conforme Torres, Roberta Muscia, Virginia Gregorio, Claudia Delogu, Ignazio Marzio Parisi, Michele Dota, Giovanni Arpa, Carolina Cicalini and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Alimentary pharmacology & therapeutics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Stiliano MaimarisDepartment of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy.ORCID https://orcid.org/0000-0003-2057-8179
Annalisa SchiepattiDepartment of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy.ORCID https://orcid.org/0000-0002-8493-7698
Daniel Ignacio Conforme TorresDepartment of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy.
Roberta MusciaDepartment of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy.
Virginia GregorioDepartment of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy.
Claudia DeloguDepartment of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy.
Ignazio Marzio ParisiDepartment of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy.
Michele DotaDepartment of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy.
Giovanni ArpaDepartment of Molecular Medicine, Unit of Anatomic Pathology, University of Pavia, Pavia, Italy.ORCID https://orcid.org/0000-0001-7226-381X
Carolina CicaliniDepartment of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy.
Giulio MassettiDepartment of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy.
Chiara ScarcellaIstituti Clinici Scientifici Maugeri IRCCS, Gastroenterology Unit of Pavia Institute, Pavia, Italy.ORCID https://orcid.org/0000-0002-2538-0930
Paolo MinerbaDepartment of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy.
Federico BiagiDepartment of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy.ORCID https://orcid.org/0000-0002-2227-4622

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInterest in a biopsy-sparing diagnosis of coeliac disease in adults is growing.

aimsTo develop and prospectively validate a non-invasive diagnostic strategy for adults with suspected coeliac disease based on clinical features and endomysial antibodies (EmA).

methodsWe retrospectively enrolled adults investigated for coeliac disease with EmA and duodenal biopsy between January 2000 and December 2021 in cohort 1 and stratified according to age at presentation (< 45 years; ≥ 45 years) and alarm symptoms. We evaluated diagnostic outcomes and accuracy of EmA. A prospective validation cohort was enrolled between Jan-2022 and Dec-2023 (cohort 2).

resultsCohort 1 included 972 patients (641 F, mean age 42 ± 16); cohort 2 included 214 patients (145 F, 43 ± 18). In cohort 1, 35.4% were diagnosed with coeliac disease and 1.5% with non-coeliac enteropathies. Of the coeliac disease diagnoses, 173 (50.3%) were in patients < 45 years old without alarm symptoms. No concomitant major organic disorders were diagnosed in patients with coeliac disease. EmA diagnostic accuracy was 99.1% (97.4% sensitivity; 100% specificity and PPV). Regarding non-coeliac enteropathies, 87% were diagnosed among the 139 patients aged ≥ 45 years old with alarm symptoms and negative EmA. No non-coeliac enteropathies were diagnosed in patients without alarm symptoms. Findings were confirmed in cohort 2.

conclusionsLow-risk adult patients could have been safely diagnosed with coeliac disease non-invasively based on EmA without endoscopy and duodenal biopsy. Older patients with alarm symptoms should undergo endoscopy with duodenal biopsy to avoid missing non-coeliac enteropathies. Further validation of our results is necessary.

Indexed as

AutoantibodiesCeliac DiseaseAdultAgedBiopsyDuodenumFemaleHumansMaleMiddle AgedProspective StudiesRetrospective StudiesRisk AssessmentYoung AdultAutoantibodiescoeliac diseaseduodenal biopsyendoscopyglutengluten‐free dietserologyvillous atrophy

Identifiers

PMID40181591
PMCPMC12074562

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.