Another study (SP Paul et al. JPGN 2018; 66: 641-44) has shown that high anti-TTG IgA levels are reliable in establishing the diagnosis of celiac disease in asymptomatic children from high-risk groups. In this study with prospectively-collected data from 2007-2017, 84 of 157 children had anti-TTG titers >10x ULN. 75 of these 84 were from high-risk groups, mainly type 1 diabetes (36), and first degree relatives (24)
Key finding:
- All 75 with high titers from high-risk groups had histologic evidence of celiac disease.
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Related study: R Mandile et al. JPGN 2018; 66: 654-56. This prospective study showed that 19 of 35 (54%) patients with potential celiac disease had a complete clinical response on a gluten-free diet to symptoms like abdominal pain and diarrhea. Thus, in many patients with potential celiac disease, a gluten-free diet will not be effective.
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