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Two experts on celiac disease have provided 10 things that every gastroenterologist should know.
Excerpts include the following:
The best screening serology is still immunoglobulin A (IgA) tissue transglutaminase (TTG) plus total serum IgA. IgG TTG performs well in patients with known IgA deficiency.
Water immersion in the duodenum can target biopsies and permits evaluation in patients without a prior indication for biopsy.
Take four biopsies from the postbulbar duodenum and two biopsies from the bulb at the 9 o'clock and 12 o'clock positions.
Consider serologic testing in all first-degree relatives of patients with celiac disease and in second-degree relatives if sibling pairs are affected. Test patients with type 1 diabetes.
Do HLA testing for …