What To Do If... ?
1Dipartimento di Scienze Cliniche Specialistiche ed Odontostomatologiche, Università Politecnica delle Marche, Ancona
According to the new ESPGHAN guidelines for the diagnosis of CD, a confirmatory small intestinal biopsy is not necessary in genetically predisposed individuals who are symptomatic and who have a tTGA of at least 10 times the upper limit of normal, a positive EMA and a good clinical response to the gluten free diet. By contrast, in asymptomatic individuals or with a tTGA that doesn’t reach 10 times the upper limit of normal, a small intestinal biopsy should still be performed. If the parents do not agree,it is necessary to start gluten-free-diet to avoid complications. It is worthy of note that the small intestinal biopsy is not required to get the gluten- free products.