Diagnosis of coeliac disease without a biopsy is possible with high specificity in adults and children, although the sensitivity is low, a UK study suggests.

Researchers looked at three cohorts: 740 patients treated at a specialist coeliac clinic in Sheffield, a further 532 referred for upper gastrointestinal endoscopy with a low suspicion for coeliac disease, and 145 patients with high with IgA antitissue transglutaminase (tTG) antibody from several sites.

Among the first cohort, the sensitivity and specificity of having 10-fold elevated IgA tTG antibodies above the upper limit of normal for identifying individuals with histology indicative of coeliac disease on biopsy (Marsh stage 3) were 54% and 90%, respectively.

In the second cohort, the corresponding estimates were 50% and 100%, and for cohort three they were 30% and 83%.