What is the role of small-bowel biopsy in the diagnosis of celiac disease?

Updated: Oct 10, 2018
  • Author: Stephan U Goebel, MD; Chief Editor: BS Anand, MD  more...
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Answer

Celiac disease was confirmed by small-bowel biopsy in 153 (2.1%) children from a group of 192 (2.7%) with elevated levels of tissue transglutaminase–immunoglobulin A or tissue transglutaminase–immunoglobulin G. [15]  The frequency of celiac disease detected was similar among children with and those without any associated celiac disease symptoms (2.1% in both groups) or celiac disease–associated conditions (3.6% vs 2.1%, respectively). [14, 15]  The sensitivity of this case-finding questionnaire was 38%, the specificity was 63%, the positive predictive value was 2%, and the negative predictive value was 98%. [15]

A study that assessed the prevalence of serologic markers of celiac disease in Italian patients referred to a rheumatology outpatient clinic found a high prevalence of antibodies to celiac disease. [56] The investigators suggested patients who present with rheumatologic features should be considered for screening for celiac disease.


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