Elevated tissue transglutaminase immunoglobulin A (tTG-IgA) in isolation is insufficient to diagnose celiac disease in children, a large pediatric cohort study in North America found.

Because tTG-IgA assay performance varied widely across labs, diagnostic confirmation by a specialist is essential before gluten-targeted dietary changes are made, according to Denis Chang, MD, MS, of the Division of Gastroenterology and Nutrition at Boston Children’s Hospital in Boston, and colleagues reported in Pediatrics .

Denis Chang, MD, MS

“Currently, small intestinal biopsy is the gold standard for diagnosing pediatric celiac disease, but recent European diagnostic criteria allow a nonbiopsy pathway for serologic diagnosis,” Chang told Medscape Medical News . The European guidelines allow

See Full Page