Exploring a Non-Biopsy Approach for Diagnosing Celiac Disease in Symptomatic Adults

Celiac.com 03/11/2024 - Celiac disease, a condition triggered by gluten sensitivity in genetically susceptible individuals, affects approximately 1% of the global population. Traditionally, diagnosing celiac disease involves a stepwise process, beginning with blood tests to detect antibodies against tissue transglutaminase (tTG), followed by an invasive duodenal biopsy to confirm the diagnosis. However, this biopsy procedure poses risks and discomfort to patients.

Recent research has explored the feasibility of diagnosing celiac disease without the need for a biopsy, relying solely on serological markers. A team of scientists conducted a retrospective analysis of medical records from biopsy-diagnosed celiac disease patients. They specifically examined the correlation between the severity of intestinal damage, as assessed by Marsh grading, and levels of anti-tTGA antibodies in the blood.

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The research team included Parul Punia, Kiran Bala, Mansi Verma, Ankita Nandi, Parveen Mahlotra, Sunita Singh, Seema Garg, Aparna Parmar, and Devender Kumar. They are variously affiliated with the departments of Microbiology, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, IND; Microbiology, PGIMS, Rohtak, IND; Gastroenterology, PGIMS, Rohtak, IND; and Microbiology, bps khanpur gmch, Sonepat, IND.

Severity of Marsh Lesions Corresponds to Anti-tTGA Antibody Levels

Their study included 94 symptomatic celiac disease patients with available anti-tTGA antibody reports. Among these patients, those with more severe intestinal damage, categorized as Marsh grade 3 lesions, consistently exhibited higher levels of anti-tTGA antibodies. Remarkably, serum antibody levels exceeding ten times the upper limit of normal (ULN) were strongly associated with Marsh grade 3 lesions.

These findings suggest that in symptomatic adults with celiac disease, the severity of intestinal damage may be accurately predicted using blood tests alone, without the need for invasive biopsies. Specifically, anti-tTGA antibody levels exceeding ten times the ULN could serve as a reliable indicator of Marsh grade 3 lesions.

Adopting a non-biopsy approach to diagnose celiac disease could offer several benefits, including reduced patient discomfort, avoidance of procedural risks, and potentially faster diagnosis and initiation of treatment. However, further research and validation studies are warranted to confirm the reliability and effectiveness of this approach across diverse patient populations.

In conclusion, the non-biopsy approach for diagnosing celiac disease represents a promising avenue for improving patient care, and diagnostic efficiency, in people with celiac disease.

Read more at Cureus.com