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Celiac disease (CD) currently is diagnosed using both serologic testing (i.e., IgA anti–tissue transglutaminase [tTG] and anti-endomysial antibodies) and small bowel biopsy. Recent pediatric guidelines suggest that a high titer of tTG is sufficient to make the diagnosis and to start treatment without biopsy confirmation (J Pediatr Gastroenterol Nutr 2012; 54:136).
Investigators studied the sensitivity and specificity of high titers of tTG (i.e., ≥10 times the upper limit of normal [10×ULN]) in diagnosing adult CD. Three cohorts were studied retrospectively: Cohort 1 comprised 740 patients who were referred to a U.K. CD clinic (CD prevalence, 93%); cohort 2 comprised 778 U.K. patients who were referred for routine endoscopy (CD prevalence, 3.…