Endomysial antibodies or anti-tissue transglutaminase type 2 IgA antibodies as a confirmatory test in children with celiac disease

Amir Ben-Tov*, Tomer Achler, Rochelle Fayngor, Raanan Shamir, Lia Supino, Yael Weintraub, Anat Yerushalmy-Feler, Shlomi Cohen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

The no-biopsy approach to diagnose celiac disease (CD), introduced in the 2012 European Society for Gastroenterology and Hepatology and Nutrition guidelines, requires an anti-endomysial antibody (EMA) confirmatory serology test following a high-positive immunoglobulin A anti-tissue transglutaminase-2 (anti-TG2) antibody ≥10 times the upper limit of normal (ULN). The aim of this retrospective study is to compare EMA positivity and high-positive anti-TG2 in patients who had their confirmatory test within 2 months of their first high-positive anti-TG2 test. Among 933 patients who had high-positive anti-TG2 serology more than 10 times the ULN in their first sample, all had both high-positive anti-TG2 and positive EMA, most of them with very high EMA titers (99.6%) in their confirmatory test. In conclusion, we suggest that a repeated anti-TG2 test can replace the EMA test as the confirmatory serology test for the confirmation of the diagnosis of CD in the no-biopsy approach.

Original languageEnglish
Pages (from-to)147-150
Number of pages4
JournalJournal of Pediatric Gastroenterology and Nutrition
Volume80
Issue number1
DOIs
StatePublished - Jan 2025

Keywords

  • biopsy
  • diagnosis
  • serology

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