Serological Markers and/or Intestinal Biopsies in the Case-finding of Celiac Disease

Aaron Lerner¹, Sandra Neidhöfer² and Torsten Matthias²

¹Pediatric Gastroenterology and Nutrition Unit, Carmel Medical Center, B. Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel

²Aesku.Kipp Institute, Wendelsheim, Germany

Cite this paper:
Aaron Lerner, Sandra Neidhöfer and Torsten Matthias. Serological Markers and/or Intestinal Biopsies in the Case-finding of Celiac Disease. International Journal of Celiac Disease. 2015; 3(2):53-55. doi: 10.12691/ijcd-3-2-7

Abstract

The new 2012 ESPGHAN guidelines for the pediatric diagnosis of celiac disease (CD) unraveled and stimulated an old/new discussion on the most efficient case- finding in pediatric CD. The fine balance between reliable serological markers and the gold diagnostic standard of small bowel histology is somewhat better understood. Due to a low diagnostic rate, changes in phenotype, increased incidence, epidemiological shifts, importance of early implementation of gluten free diet to prevent complications, the case-finding of CD should be improved. Our adult gastrointestinal colleagues did not adopt ESPGHAN diagnostic criteria and within the pediatric gastroenterology community, controversies exist. The present editorial on pediatric CD complements an adult CD one. It expands on the drawbacks, limitations and criticisms of the guidelines and calls for prudency, further research and follow-up studies. Until recent observations are implemented in the future guidelines, small bowel histology should remain the gold standard for case-finding in CD.

Keywords:
celiac disease case-finding diagnosis serology intestinal biopsy children

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