Jump to content
This site uses cookies. Continued use is acceptance of our Terms of Use and Privacy Policy. More Info... ×
  • Welcome to Celiac.com!

    You have found your celiac tribe! Join us and ask questions in our forum, share your story, and connect with others.




  • Celiac.com Sponsor (A1):



    Celiac.com Sponsor (A1-M):


  • Get Celiac.com Updates:
    Support Our Content
    eNewsletter
    Donate
  • Jefferson Adams
    Jefferson Adams

    Blood Test Alone Can Diagnose Celiac Disease in Most Children and Adults

    Reviewed and edited by a celiac disease expert.

    A new study supports using serology tests instead of biopsy to diagnose celiac disease in both children and adults. Here's what they found.

    Blood Test Alone Can Diagnose Celiac Disease in Most Children and Adults - Image: CC BY 2.0--kalyan02
    Caption: Image: CC BY 2.0--kalyan02

    Celiac.com 04/04/2022 - Consensus is building among researchers and clinicians for skipping biopsy, and diagnosing celiac disease in both children and adults using antibody tests alone.

    A team of researchers recently set out to assess the diagnostic accuracy of serological tests for celiac disease in adults and children. The research team included Athena L. Sheppard; Martha M. C. Elwenspoek; Lauren J. Scott; Victoria Corfield; Hazel Everitt; Peter M. Gillett; Alastair D. Hay; Hayley E. Jones; Susan Mallett; Jessica Watson; and Penny F. Whiting.

    Celiac.com Sponsor (A12):
    They are variously affiliated with the The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK; the Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; the Primary Care Research Centre, Faculty of Medicine, University of Southampton, Southampton, UK; the Paediatric Gastroenterology Department, Royal Hospital for Children and Young People, Edinburgh, UK; and the Centre for Medical Imaging, University College London, London, UK.

    The team searched seven electronic databases between January 1990 and August 2020 and looked for diagnostic studies that assessed the accuracy of serological tests for celiac disease against duodenal biopsy.  They used QUADAS-2 to determine bias risk, along with bivariate random-effects meta-analyses to estimate serology sensitivity and specificity at the most commonly reported thresholds.

    They included over one-hundred and ten studies covering nearly thirty thousand patients, all in secondary care populations. Due to variations in diagnostic thresholds, they included a subset of studies in meta-analyses. 

    Overall sensitivity and specificity of immunoglobulin A (IgA) anti-tissue transglutaminase were 90.7% and 87.4%, respectively, in adults, and 97.7% and 70.2% respectively in children.

    Overall sensitivity and specificity of IgA endomysial antibodies were 88.0% and 99.6% in adults, and 94.5% and 93.8% in children.

    Anti-tissue transglutaminase sensitivity appears to be sufficient to rule out celiac disease in children. 

    The high specificity of endomysial antibody in adults supports clinical use to rule in celiac disease. 

    This evidence supports the serological diagnosis of celiac disease without biopsy. The research team calls for additional studies in primary care to assess serological testing strategies.

    This news will come as a relief to anyone who has been made to eat gluten for a few weeks, and suffer a biopsy to get a celiac diagnosis. We truly are on a new threshold of celiac diagnosis, where biopsy will soon be a rare tool, and serological testing will deliver an accurate diagnosis.

    Stay tuned for more on this and related stories. 

    Read more in pubmed.ncbi.nlm.nih.gov



    User Feedback

    Recommended Comments



    Guest GFcookiemonster

    Posted

    If this is an antibody test, why doesn't it require the person to have been eating gluten? I am not sure I understand. Thanks.

    Link to comment
    Share on other sites
    trents
    2 minutes ago, Guest GFcookiemonster said:

    If this is an antibody test, why doesn't it require the person to have been eating gluten? I am not sure I understand. Thanks.

    It doesn't say that you don't have to have been eating gluten before the serological antibody test. It is saying that after you have the antibody test and your test is decisively positive then there is no need to do a gluten challenge after that in order to prevent a false negative for the biopsy since there is no need now for the biopsy.

    Link to comment
    Share on other sites
    Guest GFcookiemonster

    Posted

    3 hours ago, trents said:

    It doesn't say that you don't have to have been eating gluten before the serological antibody test. It is saying that after you have the antibody test and your test is decisively positive then there is no need to do a gluten challenge after that in order to prevent a false negative for the biopsy since there is no need now for the biopsy.

    I'm sorry, I just don't understand (too many negatives in that first sentence lol).  I think you are saying it's possible to determine if you have celiac with this serological antibody test even if you are on a gluten-free diet. That is, you do not have to eat gluten for this test to be accurate. Do I understand that correctly?  And if this is the case, why would there be antibodies to gluten in the blood if you were not being exposed to it. I am clearly missing something. Thank you so much. 

    Link to comment
    Share on other sites
    Elizabeth Butler
    4 hours ago, Guest GFcookiemonster said:

    If this is an antibody test, why doesn't it require the person to have been eating gluten? I am not sure I understand. Thanks.

    This is not surprising! I may be a simpleton but I know know three things. One the “healthcare industry” is just that. I’m going on 20 years in healthcare and it’s a business. Sick people drum up ALOT OF BUSINESS. Two: science moves slow especially in medicine. Lastly I learned in basic anatomy that endothelial tissue is found all over the body. The skin and the “skin” of the GI Tract share some qualities. Blood is also the substance that brings life and ends it. So it is no surprise that a blood test shows a reaction to “gluten”. Also for those suffering dermatitis herpetiformis we know the skin shows when we’ve had gluten. As soon as I had an allergy test show a wheal to grasses, I cut gluten and most other grasses out of my dietary choices. I don’t miss them and what they do to my body. My wallet was much happier for it too. I’m not nutritiously void either. Everything offered by grasses can be found in other sources. You just have to branch out from French fries and hamburgers. I’m so glad to see this making headway for celiac. I think just like diabetes it’s insidious nature is downplayed because GI symptoms and surgery MAKE HOSPITALS ALOT OF MONEY! 

    Link to comment
    Share on other sites
    trents

    Guest GFCookieMonster, See my reply with your quote below.

    Edited by trents
    Link to comment
    Share on other sites
    trents
    22 minutes ago, Guest GFcookiemonster said:

    I'm sorry, I just don't understand (too many negatives in that first sentence lol).  I think you are saying it's possible to determine if you have celiac with this serological antibody test even if you are on a gluten-free diet. That is, you do not have to eat gluten for this test to be accurate. Do I understand that correctly?  And if this is the case, why would there be antibodies to gluten in the blood if you were not being exposed to it. I am clearly missing something. Thank you so much. 

    The serological test will not be valid if you have been off gluten for a significant period of time, say for weeks. The article is not contradicting this reality. It is saying that if your serological test was indeed strongly positive there is no need to go through the pain and hassle of going back on gluten just to have a biopsy. Is that clearer? I think you were not understanding correctly the point the article was trying to make.

    Link to comment
    Share on other sites
    Elizabeth Butler
    1 minute ago, trents said:

    The serological test will not be valid if you have been off gluten for a significant period of time, say for weeks. The article is not contradicting this reality. It is saying that if your serological test was indeed strongly positive there is no need to go through the pain and hassle of going back on gluten just to have a biopsy. Is that clearer? I think you were not understanding correctly the point the article was trying to make.

    The point of the article is mute. Science is too slow and hardly any money dedicated to food and nutrition just drugs. It shouldn’t take twenty years to find out blood can tell us just about anything we need to know. It controls everything in our body in one way or another. How many celiacs suffering already knew by their own bodies telling them something was wrong or something is getting better. Instead they listened to a doctor who said “ well we would want to be sure your actually celiac before you just cut out the nutritional value of those foods”. Doctors don’t get much education on nutrition…that should be apparent by looking at the recommendation diets for diabetes and heart disease endorsed by doctors everywhere. How much nutritional value is in a slice of white bread? Or some ritz crackers because that’s what the average person is eating. 

    Link to comment
    Share on other sites
    JD-New to Celiac
    13 hours ago, Guest GFcookiemonster said:

    If this is an antibody test, why doesn't it require the person to have been eating gluten? I am not sure I understand. Thanks.

    I can only give you my account of why this would make sense and I hope that helps to explain why this is important news. I was misdiagnosed for years and gradually became so ill to a point where I was rapidly losing weight and at a point where I could no longer eat. I am a medium framed 6ft male and was nearing 140 lbs by the time a doctor did testing for celiac. The test results showed tTg Iga levels extremely high and the doctor determined at that moment it was celiac and said a gluten free diet was necessary. I understood that to mean I should go gluten free immediately, which I did. The doctor also said I needed to see a GI doctor for follow up care as he was not a specialist. I called and I called and I called to try and get an appointment. Once I finally did get a GI appointment the earliest they could see a new patient was not for six weeks. I explained the seriousness of my condition at the time and they said they would share that with the GI but I never heard back from them. In the meantime I went off gluten and started to slowly recover and even gain back a few pounds. When I did finally get in to see the GI six weeks later, the first thing he asked was what the problem was. I told him my regular doctor did a blood test and diagnosed me with celiac. I then said the doctor told me to go gluten free. The GI responded with you can't diagnose celiac without doing a biopsy. He then said he would order a biopsy but since I went off gluten I would need to go back on it for two months. I told him I would not go through the agony of going back on gluten. So, I left his office and learned afterwards that the GI refused to treat me any longer. In fact he wrote in his report that I was self diagnosing and managing my own health. I have been gluten free for two years. Since going gluten free my tTg Iga levels have dramatically decreased. I've gained 25 pounds and although I still suffer (as many celiacs do) from a long list of ailments, I am much better since going gluten free. I thank one person on this site for giving me the courage to stand up to the GI and not do as he asked as they followed the same path that I did. There were also many on this site that did not agree. My regular doctor still has me listed as having celiac, but whenever I see a new doctor that question still comes up...did they do a biopsy. It is quite annoying. As I understand it the UK will diagnose an adult with celiac based on a blood test and when certain criteria are met.

    Link to comment
    Share on other sites
    Guest GFcookiemonster

    Posted

    12 hours ago, trents said:

    The serological test will not be valid if you have been off gluten for a significant period of time, say for weeks. The article is not contradicting this reality. It is saying that if your serological test was indeed strongly positive there is no need to go through the pain and hassle of going back on gluten just to have a biopsy. Is that clearer? I think you were not understanding correctly the point the article was trying to make.

    Yes, thank you so much for the clarification. I do understand now. Appreciate your reply!

    Link to comment
    Share on other sites
    trents
    32 minutes ago, Guest GFcookiemonster said:

    Yes, thank you so much for the clarification. I do understand now. Appreciate your reply!

    You're certainly welcome! Have a great day.

    Link to comment
    Share on other sites
    Jessica72ism
    14 hours ago, Elizabeth Butler said:

    The point of the article is mute. Science is too slow and hardly any money dedicated to food and nutrition just drugs. It shouldn’t take twenty years to find out blood can tell us just about anything we need to know. It controls everything in our body in one way or another. How many celiacs suffering already knew by their own bodies telling them something was wrong or something is getting better. Instead they listened to a doctor who said “ well we would want to be sure your actually celiac before you just cut out the nutritional value of those foods”. Doctors don’t get much education on nutrition…that should be apparent by looking at the recommendation diets for diabetes and heart disease endorsed by doctors everywhere. How much nutritional value is in a slice of white bread? Or some ritz crackers because that’s what the average person is eating. 

    The Bible says let thy food by by medicine.

    Link to comment
    Share on other sites
    trents
    31 minutes ago, Jessica72ism said:

    The Bible says let thy food by by medicine.

    Book, chapter and verse please. Your quote comes from Hippocrates, The Greek physician who is considered to be the father of medicine.

    Link to comment
    Share on other sites



    Create an account or sign in to comment

    You need to be a member in order to leave a comment

    Create an account

    Sign up for a new account in our community. It's easy!

    Register a new account

    Sign in

    Already have an account? Sign in here.

    Sign In Now

  • Get Celiac.com Updates:
    Support Celiac.com:
    Donate
  • About Me

    Jefferson Adams

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University. His articles, essays, poems, stories and book reviews have appeared in numerous magazines, journals, and websites, including North American Project, Antioch Review, Caliban, Mississippi Review, Slate, and more. He is the author of more than 2,500 articles on celiac disease. His university coursework includes studies in science, scientific methodology, biology, anatomy, physiology, medicine, logic, and advanced research. He previously devised health and medical content for Colgate, Dove, Pfizer, Sharecare, Walgreens, and more. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of numerous books, including "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

    >VIEW ALL ARTICLES BY JEFFERSON ADAMS

     


  • Celiac.com Sponsor (A17):
    Celiac.com Sponsor (A17):





    Celiac.com Sponsors (A17-M):




  • Related Articles

    Jefferson Adams
    Kids Can Get Accurate Celiac Diagnosis Without Biopsy
    Celiac.com 08/07/2017 - The guidelines of the European Society of Pediatric Gastroenterology, Hepatology, and Nutrition allow for diagnosis of celiac disease without biopsies in children with symptoms and levels of immunoglobulin A against tissue-transglutaminase (TGA-IgA) 10-fold or more the upper limit of normal (ULN), confirmed by detection of endomysium antibodies (EMA) and positivity for HLA-DQ2/DQ8.
    To validate this approach, a team of researchers recently performed a large, international prospective study. The primary goal was to see if the non-biopsy approach can identify children with celiac disease with a positive predictive value (PPV) above 99% in clinical practice. That means they want to make sure doctors can get it right at least 99 times out of 100 in the office. They...


    Jefferson Adams
    These Three Traits Can Spot Celiac Disease in Adults Without Biopsy
    Celiac.com 01/07/2019 - Researchers have made progress in spotting celiac disease without biopsy in children with certain parameters. Can the same be done for adults? A team of researchers recently set out to evaluate the accuracy of serology-based criteria in adults with variable pre-test probabilities for celiac disease. The research team included V Fuchs, K Kurppa, H Huhtala, K Laurila, M Mäki, P Collin, T Salmi, L Luostarinen, P Saavalainen, and K Kaukinen.
    New criteria for diagnosing celiac disease in children allow doctors to forgo duodenal biopsies in children who have symptoms, positive blood tests, and celiac disease-associated genes. 
    There’s currently no good data on whether such an approach might work for adults with certain clinical presentations of celiac dis...


    Scott Adams
    One Blood Test Can Now Diagnose Celiac Disease without Biopsy
    Celiac.com 09/24/2020 - Celiac disease is an autoimmune condition in which eating wheat, rye, or barley triggers an adverse immune reaction in the gut. Celiac disease affects about one percent of the population. Diagnosis can be a long and arduous process. In the United States, the average person with celiac disease can wait up to ten years from the time of first symptoms to diagnosis. Left undiagnosed, autoimmune disease can cause organ damage and bowel cancer.
    Anyone who has ever had to suffer through a long, convoluted process to get their celiac disease diagnosis can now rejoice for any new celiacs going forward. That's because researchers have developed a single blood test that can diagnose celiac disease without biopsy. Until now, the "gold standard" for celiac diagnosis was...


    Scott Adams
    No Biopsy Needed to Accurately Diagnose Celiac Disease in Nearly All Adults
    Celiac.com 12/14/2020 - The science behind celiac disease diagnosis has been moving rapidly away from biopsy. First, biopsy screening was eliminated for celiac diagnosis in most children. Then, the European Society for the Study of Paediatric Gastroenterology, Hepatology and Nutrition guidelines suggested that celiac disease can be diagnosed without taking duodenal biopsies. The latest diagnostic guidelines suggest that a 10-fold increase in IgA antitissue transglutaminase (tTG) antibody levels, in combination with EMA positivity, supports a diagnosis of celiac disease, without the need for a duodenal biopsy. 
    However, this approach has not yet been widely adopted into clinical practice for diagnosing adults, mainly due to a limited international multi-center data, and testing in ...


  • Recent Activity

    1. - trents replied to Brianne03's topic in Gluten-Free Foods, Products, Shopping & Medications
      1

      Chapstick, gum, cough drops, medications...HELP!

    2. - Brianne03 posted a topic in Gluten-Free Foods, Products, Shopping & Medications
      1

      Chapstick, gum, cough drops, medications...HELP!

    3. - Scott Adams replied to gregoryC's topic in Traveling with Celiac Disease
      18

      Celebrity Cruise for Gluten Free

    4. - Jordan Carlson posted a topic in Post Diagnosis, Recovery & Treatment of Celiac Disease
      0

      Neurological/Nervous System Symptoms

    5. - aperlo34 replied to Dimitri berveglieri's topic in Post Diagnosis, Recovery & Treatment of Celiac Disease
      5

      burning sensation after going gluten free


  • Celiac.com Sponsor (A19):



  • Member Statistics

    • Total Members
      125,991
    • Most Online (within 30 mins)
      7,748

    terry bradshaw
    Newest Member
    terry bradshaw
    Joined

  • Celiac.com Sponsor (A20):


  • Forum Statistics

    • Total Topics
      120.9k
    • Total Posts
      69.1k

  • Celiac.com Sponsor (A22):





  • Celiac.com Sponsor (A21):



  • Popular Now

    • Bindi
      38
    • Jordan Carlson
      8
    • gregoryC
  • Popular Articles

    • Scott Adams
    • Scott Adams
    • Scott Adams
    • Scott Adams
    • Scott Adams
  • Upcoming Events

×
×
  • Create New...