BIOPSY NOT ALWAYS NECESSARY FOR DIAGNOSIS

There is high diagnostic accuracy of immunoglobulin-A-tissue transglutaminase antibodies for detecting celiac disease. Researchers explored whether a small bowel biopsy is always required to establish the diagnosis. The team defined the transglutaminase antibody level giving a positive predictive value for celiac disease of 100 percent and assessed the proportion of new diagnoses of celiac disease having such a result. The Celikey kit was used to measure transglutaminase antibody levels.

The researchers observed that all patients with transglutaminase antibody levels over 30 U/mL had characteristic small bowel mucosal lesions. In a subsequent audit, 58 percent of 112 new diagnoses of celiac disease in 2004 to 2005 had levels above this cut-off value. From published data, the team showed their observations can be extended to most second-generation transglutaminase antibody kits.