Which statement is accurate regarding celiac disease diagnosis?

Which statement is accurate regarding celiac disease diagnosis?

• A. Intestinal biopsy is needed for formal diagnosis
• B. Serology alone is sufficient
• C. Gluten-free diet started before testing
• D. There is no testing protocol

Answer: (B)

Key idea: the diagnostic power of well-chosen serologic tests in celiac disease. Certain antibodies produced in response to gluten—principally tissue transglutaminase IgA and endomysial antibodies—are highly accurate indicators of celiac disease when a patient is still eating gluten. If a person has compatible symptoms and positive serology, the likelihood of true disease is very high, so in many testing pathways serology alone can establish the diagnosis without waiting for an intestinal biopsy. It’s important to confirm that the patient has normal total IgA because IgA deficiency can mask positivity; in that case, alternative testing using IgG-based antibodies is used. While biopsy remains a common confirmatory step in many scenarios, the serology-centered approach is considered sufficient in situations where the serologic results are clearly supportive and the clinical picture fits.

Key idea: the diagnostic power of well-chosen serologic tests in celiac disease.

Certain antibodies produced in response to gluten—principally tissue transglutaminase IgA and endomysial antibodies—are highly accurate indicators of celiac disease when a patient is still eating gluten. If a person has compatible symptoms and positive serology, the likelihood of true disease is very high, so in many testing pathways serology alone can establish the diagnosis without waiting for an intestinal biopsy. It’s important to confirm that the patient has normal total IgA because IgA deficiency can mask positivity; in that case, alternative testing using IgG-based antibodies is used. While biopsy remains a common confirmatory step in many scenarios, the serology-centered approach is considered sufficient in situations where the serologic results are clearly supportive and the clinical picture fits.