A recent prospective cohort study suggests that a blood test might be a reliable method for diagnosing some adults with suspected celiac disease, potentially eliminating the need for a biopsy. In the study of 436 adults without IgA deficiency, a serum anti-tissue transglutaminase IgA (tTG-IgA) test was compared with the gold standard of duodenal biopsy. The serum test identified 348 true positives and 66 true negatives but also had 15 false positives and seven false negatives. The research, led by Carolina Ciacci, MD, from the University of Salerno in Italy, found the blood test’s positive predictive value to be 95.9% and its negative predictive value to be 90.4%.
While several clinical studies have shown the tTG-IgA test’s feasibility in children, it hasn’t been widely adopted for adults. Despite the promising results, a spokesperson for the American Gastroenterological Association advised that biopsy should remain the standard diagnostic method. Benjamin Lebwohl, MD, emphasized the importance of being as certain as possible before recommending a gluten-free diet, a significant life change.
The study was conducted across 14 tertiary referral centers in various continents, including Europe, Asia, Oceania, and South America. The researchers concluded that a serology-based celiac disease diagnosis without biopsy might be possible in adults with a high pretest probability of the disease.