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  • Q&A with Australian Health Practitioners

    Is a blood test & dermatitis herpitiformis enough to diagnose coeliac?

    I had positive coeliac serology and what my doctor thinks is dermatitis herpitiformis. Do I still require a bowel biopsy or is this enough evidence. I don't really want to get a biopsy done.
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    Dr Cheng Hiang Lee

    Paediatric Gastroenterologist

    Dr Cheng Hiang LEE MB BCh BAO DipPaed (UNSW) FRACP, is a consultant paediatric and adolescent gastroenterologist who performs endoscopic procedures in children. He is … View Profile

    Yes. The small bowel biopsy is the gold standard to diagnose coeliac disease.

    However in paediatric patients, the ESPGHAN guidelines stated that if tTG IgA (one of the coeliac serology) is more than 10 times the upper limit of normal, potentially coeliac disease could be diagnosed without biopsy. This need to be supported by a second blood test, HLA test (genetic testing) and frequent followup showing improvement of coeliac serology after starting gluten free diet. This European guideline has not been adopted in Australia.

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