Abstract
For high prevalence celiac disease (CD) is one of the most important diseases of the digestive tract. Patients are approximately 1% in the population and therefore a search for this disease is necessary.
The first step in the diagnosis of CD is to test antibodies to tissue transglutaminase in class A immunoglobulins (anti-TG-IgA) and to eliminate IgA deficiency by determining its total value. This combination of total IgA and anti-TG- IgA is the most accurate and cost-effective initial testing.
At this time, there is no need to test antibodies to endomysium in class IgA (EMA-IgA) and antibodies to deamided gliadin in class G immunoglobulins (anti-DGP-IgG). If the child was twice found high values of the anti-TG-IgA >10 times the upper normal limit (ULN), i.e. even in the second blood sample and at the same time was also positive EMA-IgA, it is possible to make the diagnosis of CD without biopsy.
Children who have been found to have an anti-TG-IgA value <10 times ULN should undergo an intestinal biopsy to reduce the risk of false positive diagnosis. HLA testing and presence of symptoms are not needed for a sérology based diagnosis without biopsy.