New aspects in celiac disease

Table 2 Diagnosis in celiac disease

Diagnostic criteria used in celiac disease	Diagnostic propose for celiac disease	Comments
Serological test:	With classical symptoms:	Positive serology supports a diagnosis of CD, but they are not
Tissue transglutaminase antibody (tTGA)	Serological test:	essential. Compatible with HLA-DQ2/D8 testing and identify
Endomysial antibody (EMA)	Tissue transglutaminase antibody (tTGA)	individuals for further biopsy evaluation. Small bowel biopsy
Gliadin antibodies (AGA)	Endomysial antibody (EMA)	is critical in symptomatic patients with negative serology for
Total IgA	Gliadin antibodies (AGA)	CD and with HLA compatible with the disease
Endoscopy	HLA-DQ2/DQ8 testing	Determination of HLA typing as a first step in diagnosis in CD family
	Capsule endoscopy (with adequate pathological interpretation)	Adequate number of biopsies and well oriented. Estimate lymphocyte infiltration and partial or total villus atrophy
	Without classical symptoms HLA-DQ2/DQ8 testing	Primordial role of HLA-typing if serology is negative and with biopsy refused or equivocal to identify individuals
	Serologic test:	Adequate number of biopsies and well oriented. Estimate
	Tissue transglutaminase antibody (tTGA)	lymphocyte infiltration and partial or total villous atrophy
	Endomysial antibody (EMA)
	Gliadin antibodies (AGA)
	Capsule endoscopy (with adequate pathological interpretation)