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European guidelines suggest that in children and adolescents with symptoms compatible with coeliac disease, the diagnosis can be made without the need for intestinal biopsy if anti-tTG antibodies titres are very high (10 times the upper limit of normal). [8] Until the 1970s, biopsies were obtained using metal capsules attached to a suction device.
European guidelines suggest that in children and adolescents with symptoms which are compatible with coeliac disease, the diagnosis can be made without the need for an intestinal biopsy if anti-tTG antibodies titres are very high (10 times the upper limit of normal). [9]
Autoimmune conditions related to gluten include celiac disease, dermatitis herpetiformis, and gluten ataxia.There is research showing that in people with gluten ataxia early diagnosis and treatment with a gluten-free diet can improve ataxia and prevent its progression. [9]
Children with celiac disease often present with symptoms like abdominal distension or bloating, as well as failure to thrive, anemia and diarrhea. Because these symptoms are vague and can be related to many other conditions or food allergies, celiac disease can be difficult to diagnose unless there is a family history to help as a cue.
Celiac disease affects ~1% of the population in most parts of the world. [3] Ninety to one hundred percent of patients with coeliac disease have inherited genes at the HLA-DQ locus that encode HLA-DQ2 and/or HLA-DQ8 serotype proteins. [12] About 2–3% of individuals who inherit these HLA-DQ2 and/or HLA-DQ8 serotypes develop coeliac disease. [10]
Most attention to anti-transglutaminase antibodies is given with respect to celiac disease. A recent study of children published in 2007 demonstrated that the level of ATA in correlates with the scalar Marsh score for the disease in the same patient. [9] High levels of ATA are found in almost all instances of celiac disease. [10]
As antibody-negative coeliac disease is recognised, HLA status, persistence or progression of the duodenal IEL numbers following a gluten challenge, followed by symptomatic improvement on a gluten-free diet, has been used to be more certain about the diagnosis, which was made in 22% of one series of over 200 adult cases. [5]
Anti-gliadin antibodies were one of the first serological markers for coeliac disease. Problematic with AGA is the typical sensitivity and specificity was about 85%. Gliadin peptides which are synthesized as the deamidated form have much higher sensitivity and specificity, creating 2 serological tests for CD that approach biopsy diagnostic in ...