Endoscopy Learning Library
Francesco Valitutti (1) e Carlo Catassi (2)
1U.O.C. di Gastroenterologia, Epatologia e Endoscopia Digestiva Pediatrica, Sapienza Università di Roma2Dipartimento di Scienze Cliniche Specialistiche ed Odontostomatologiche, Università Politecnica delle Marche di Ancona
In 2012 the ESPGHaN updated the diagnostic criteria for celiac disease (cd). Physicians who take care of pediatric patients with cd must be aware that, in a very specific clinical scenario, the diagnosis could be established without intestinal biopsies: this concerns patients with clinical features of cd who display high anti-tTg antibody titer (>10 upper limit normal), Ema positive and HLa-dQ2 or -dQ8. For all other cases, multiple biopsies (at least 1 from the bulb and at least 4 from the 2nd/3rd duodenal portion) must be provided in order to identify histological lesions compatible with cd.