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What is the use of biopsy and antibodies in coeliac disease diagnosis?
Author(s) -
Evans K. E.,
Sanders D. S.
Publication year - 2011
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.2011.02380.x
Subject(s) - medicine , coeliac disease , biopsy , serology , context (archaeology) , disease , endoscopy , antibody , radiology , pathology , immunology , paleontology , biology
. Evans KE, Sanders DS (Royal Hallamshire Hospital, Sheffield, UK). What is the use of biopsy and antibodies in coeliac disease diagnosis? (Symposium). J Intern Med 2011; 269 : 572–581. The advent of highly sensitive and specific serological markers has led to some protagonists proposing that coeliac disease can be diagnosed without the need for a biopsy. However, this is an area of controversy. Lack of consensus about diagnostic degrees of histological change, paucity of symptoms, antibody‐negative disease and immunodeficiency can make diagnosis difficult even with a biopsy. Conversely, an argument can be put forward for a ‘no biopsy’ approach based on the large number of patients with typical symptoms and positive serology who experience a diagnostic delay. In addition, endoscopy is not without discomfort. This article discusses the use of antibodies and duodenal biopsy within this context. Finally, we propose a pragmatic diagnostic algorithm for clinicians to use when investigating patients for coeliac disease.