Published online September 30, 2005
PEDIATRICS Vol. 116 No. 4 October 2005, pp. 1055 (doi:10.1542/peds.2005-1710)
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Right arrow Nutrition & Metabolism

Diagnosing Celiac Disease With a Positive Serological Test and Without an Intestinal Biopsy: In Reply

Collin C. Barker, MD
Department of Pediatrics

Thomas Mock, PhD
Department of Pathology and Laboratory Medicine
British Columbia Children's Hospital,
University of British Columbia,
Vancouver, British Columbia, Canada V6H 3V4

The first 20% of the full text of this article appears below.

In Reply.—

We agree with Dr Rashid that it is too early to abandon the small-intestinal biopsy for diagnosing celiac disease accurately. We currently continue to biopsy all patients who potentially have celiac disease.

Our study1 was a small retrospective study that found that most children with a very high tissue transglutaminase antibody titer (>100 units on the assays used) had a positive small-intestinal biopsy for celiac disease. These results need confirmation with larger prospective cohorts to determine if this observation can be replicated. It is recognized that results from preliminary clinical investigations do not always concur with results from subsequent, large, comparative trials. Therefore, we recommended in our discussion section that larger and more robust . . . [Full Text of this Article]