It’s very likely that the biopsy will remain the gold standard for years to come; approximately 90% of new cases are diagnosed using an endoscopic biopsy as part of the diagnosis. Only in rare cases is a diagnosis made without a biopsy as part of the diagnosis. In these rare cases a patient must have at least one of the genes for celiac disease, tTG and EMA elevated more than 10x normal, and a positive response to a gluten-free diet. Those who should receive a biopsy to diagnose celiac disease include those with:

• Positive antibody blood test prior to starting a gluten-free diet.
• Unexplained iron deficiency anemia not responding to therapy.
• Early osteoporosis.
• Neuropathy/ataxia.

  December, 2012