Coeliac Disease: to Biopsy or Not?

Overview

Journal Nat Rev Gastroenterol Hepatol

Specialty Gastroenterology

Date 2017 Oct 12

PMID 29018278

Citations 13

Authors

Norelle R Reilly

Steffen Husby

David S Sanders

Peter H R Green

Affiliations

Soon will be listed here.

Abstract

Coeliac disease is increasingly recognized as a global problem in both children and adults. Traditionally, the findings of characteristic changes of villous atrophy and increased intraepithelial lymphocytosis identified in duodenal biopsy samples taken during upper gastrointestinal endoscopy have been required for diagnosis. Although biopsies remain advised as necessary for the diagnosis of coeliac disease in adults, European guidelines for children provide a biopsy-sparing diagnostic pathway. This approach has been enabled by the high specificity and sensitivity of serological testing. However, these guidelines are not universally accepted. In this Perspective, we discuss the pros and cons of a biopsy-avoiding pathway for the diagnosis of coeliac disease, especially in this current era of the call for more biopsies, even from the duodenal bulb, in the diagnosis of coeliac disease. In addition, a contrast between paediatric and adult guidelines is presented.

Citing Articles

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Insights into coeliac disease diagnosis: a 2021-2023 overview of diagnostic approach and delays in children in Slovenia.

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Preparation and Immunochemical Characterization of a Water-Soluble Gluten Peptide Fraction for Improving the Diagnosis of Celiac Disease.

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Upper gastrointestinal endoscopic findings in celiac disease at diagnosis: A multicenter international retrospective study.

Stefanolo J, Zingone F, Gizzi C, Marsilio I, Espinet M, Smecuol E World J Gastroenterol. 2022; 28(43):6157-6167.

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