Recent research by a group at La Fe University Hospital in Valencia in Spain has validated the new ESPGHAN diagnostic criteria discussed by Alex Gazzola earlier this year here on CoeliacsMatter.
The researchers performed a retrospective review of all patients suspicious of having CD who had undergone a small bowel biopsy in our Gastroenterology Unit. 150 patients met the inclusion criteria and were enrolled in the study. 116 were positive for the TT: 113/116 (97.4%) had a Marsh 2/3 histological lesion and had been considered to have CD. Thus PPV of the TT was 97.4%.
The other three cases (2.6%) had Marsh 0/1 lesion, so were considered false positives for the TT. However, on follow up, all three children developed histological damage after a gluten challenge.
Finally, PPV of the TT was 100%. 34 patients were negative for the TT: 22 patients are celiac, 3 are celiac but challenge gluten diet is pending, and the 9 patients left have other gastrointestinal disorder.
They concluded that the study supported the view that in selected children who are symptomatic and positive for the Triple Test, CD diagnosis could be established independently of histological findings.
J Pediatr Gastroenterol Nutr. 2012 Oct 29.
Coeliac Disease: The New Proposed ESPGHAN Diagnostic Criteria Do Work Well in A Selected Population.
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