{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T21:20:17Z","timestamp":1788384017804,"version":"build-2803163510"},"reference-count":79,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2013,10,5]],"date-time":"2013-10-05T00:00:00Z","timestamp":1380931200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The majority of deleterious health consequences of coeliac disease (<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>) are most likely to be secondary to intestinal inflammation; hence, mucosal recovery is a desirable goal of therapy. Follow\u2010up in <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> is controversial and serological response is often used as a surrogate for histological recovery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To inform the clinical management of <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> using comparative serological and histological data from a biopsy\u2010driven pathway of care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis of the Cambridge Coeliac Clinic database of 595 patients routinely followed up by biopsy and serology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Paired biopsy results were available for 391 patients (15% seronegative). Persisting villous atrophy (<jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>) occurred in 182 patients (47%). The sensitivity of anti\u2010tissue transglutaminase (<jats:styled-content style=\"fixed-case\">TTG<\/jats:styled-content>) antibody for ongoing <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content> was only 43.6%. Information on dietetic management and further biopsy to assess response was available for 94 initially unresponsive patients, in whom targeted dietetic intervention by removal of identified gluten sources or avoidance of trace amounts of gluten led to resolution of persistent <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content> in 50%. The effects of institution of a formal care pathway are analysed in 298 patients. Discharge to primary care and clinical management was facilitated by the information derived from repeat biopsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Serology appears to be a poor surrogate marker for mucosal recovery on a gluten\u2010free diet; dietary assessment fails to identify a potential gluten source in many patients with ongoing villous atrophy. The benefits of re\u2010biopsy on diet include stratification of patients with coeliac disease suitable for early discharge from secondary care or those requiring more intensive clinical management.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.12510","type":"journal-article","created":{"date-parts":[[2013,10,12]],"date-time":"2013-10-12T02:07:50Z","timestamp":1381543670000},"page":"1278-1291","source":"Crossref","is-referenced-by-count":99,"title":["Optimising delivery of care in coeliac disease \u2013 comparison of the benefits of repeat biopsy and serological follow\u2010up"],"prefix":"10.1111","volume":"38","author":[{"given":"L. 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