Diagnóstico sorológico da doença celíaca visando a diminuição da biópsia intestinal

Abstract

Celiac disease (CD) is a systemic disorder and immune-mediated by gluten in genetically susceptible individuals. IgA antibodies against tissue transglutaminase (tTG IgA) are sensitive markers used in laboratory diagnosis of CD. Currently, there are two methods used for the diagnosis of CD, serology analyzing IgA antibodies against transglutaminase, and intestinal biopsy. The article explores the protocol adopted since 2012 by the Association of American and European Gastroenterologists (ESPGHAN) that demonstrates that it is possible to evidence CD without subjecting the patient to invasive processes, such as biopsy. We analyzed 11 articles published between 1999 and 2018, in which the results reveal that it is still not possible to rule out the biopsy in some cases, especially when there is a clinical picture and IgA anti-transglutaminase antibodies less than 10 times higher than the cutoff point (cutoff). With these results, we can infer that more sensitive and more specific serological tests are still necessary to completely rule out the use of biopsy as a method of clinical diagnosis of CD.