Eur J Gastroenterol Hepatol. 2021 Dec 1;33(1S Suppl 1):e999-e1002.doi: 10.1097/MEG.0000000000002093.

Ester Donat ^1 2, Maria Roca ^1 2, Etna Masip ^1 2, Begoña Polo ^1 2, David Ramos ^2 3, Carmen Ribes-Koninckx ^1 2

Author information

¹Pediatric Gastroenterology and Hepatology Unit, Hospital Universitari i Politècnic La Fe.

²Celiac Disease and Digestive Immunopathology Unit, Instituto de Investigación Sanitaria La Fe.

³Pathology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain.

Abstract

According to European Society for Paediatric Gastroenterology, Hepatology, and Nutrition 2020 criteria for celiac disease diagnosis, the small bowel biopsy (SBB) can be omitted in selected circumstances, even in asymptomatic patients. Hence, we have conducted a retrospective study to identify the histological findings of the asymptomatic patients with antitransglutaminase IgA antibodies 10 times above the upper limit of normal and positive antiendomisium antibodies; 5/24 patients fulfilling these criteria had, however, a nonconclusive SBB and were diagnosed with potential celiac disease. The nonbiopsy approach in these cases needs to be carefully evaluated and the risk of overdiagnosis pondered as the management and evolution of potential celiac disease cases is still a matter of study.