{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T12:27:07Z","timestamp":1783945627530,"version":"3.55.0"},"reference-count":44,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T00:00:00Z","timestamp":1743638400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Interest in a biopsy\u2010sparing diagnosis of coeliac disease in adults is growing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To develop and prospectively validate a non\u2010invasive diagnostic strategy for adults with suspected coeliac disease based on clinical features and endomysial antibodies (EmA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively enrolled adults investigated for coeliac disease with EmA and duodenal biopsy between January 2000 and December 2021 in cohort 1 and stratified according to age at presentation (&lt;\u200945\u2009years; \u2265\u200945\u2009years) and alarm symptoms. We evaluated diagnostic outcomes and accuracy of EmA. A prospective validation cohort was enrolled between Jan\u20102022 and Dec\u20102023 (cohort 2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Cohort 1 included 972 patients (641\u2009F, mean age 42\u2009\u00b1\u200916); cohort 2 included 214 patients (145\u2009F, 43\u2009\u00b1\u200918). In cohort 1, 35.4% were diagnosed with coeliac disease and 1.5% with non\u2010coeliac enteropathies. Of the coeliac disease diagnoses, 173 (50.3%) were in patients &lt;\u200945 years old without alarm symptoms. No concomitant major organic disorders were diagnosed in patients with coeliac disease. EmA diagnostic accuracy was 99.1% (97.4% sensitivity; 100% specificity and PPV). Regarding non\u2010coeliac enteropathies, 87% were diagnosed among the 139 patients aged \u2265\u200945 years old with alarm symptoms and negative EmA. No non\u2010coeliac enteropathies were diagnosed in patients without alarm symptoms. Findings were confirmed in cohort 2.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Low\u2010risk adult patients could have been safely diagnosed with coeliac disease non\u2010invasively based on EmA without endoscopy and duodenal biopsy. Older patients with alarm symptoms should undergo endoscopy with duodenal biopsy to avoid missing non\u2010coeliac enteropathies. Further validation of our results is necessary.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.70129","type":"journal-article","created":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T05:34:21Z","timestamp":1743831261000},"page":"1794-1804","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Biopsy\u2010Sparing Diagnosis of Coeliac Disease Based on Endomysial Antibody Testing and Clinical Risk Assessment"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2057-8179","authenticated-orcid":false,"given":"Stiliano","family":"Maimaris","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Medical Therapy University of Pavia  Pavia Italy"},{"name":"Istituti Clinici Scientifici Maugeri IRCCS, Gastroenterology Unit of Pavia Institute  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8493-7698","authenticated-orcid":false,"given":"Annalisa","family":"Schiepatti","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Medical Therapy University of Pavia  Pavia Italy"},{"name":"Istituti Clinici Scientifici Maugeri IRCCS, Gastroenterology Unit of Pavia Institute  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Ignacio","family":"Conforme Torres","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Medical Therapy University of Pavia  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Muscia","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Medical Therapy University of Pavia  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Gregorio","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Medical Therapy University of Pavia  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Delogu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Medical Therapy University of Pavia  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignazio Marzio","family":"Parisi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Medical Therapy University of Pavia  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Dota","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Medical Therapy University of Pavia  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7226-381X","authenticated-orcid":false,"given":"Giovanni","family":"Arpa","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine, Unit of Anatomic Pathology University of Pavia  Pavia Italy"},{"name":"Unit of Anatomic Pathology, ICS Maugeri\u2010IRCCS SpA SB  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Cicalini","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Medical Therapy University of Pavia  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Massetti","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Medical Therapy University of Pavia  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2538-0930","authenticated-orcid":false,"given":"Chiara","family":"Scarcella","sequence":"additional","affiliation":[{"name":"Istituti Clinici Scientifici Maugeri IRCCS, Gastroenterology Unit of Pavia Institute  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Minerba","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Medical Therapy University of Pavia  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2227-4622","authenticated-orcid":false,"given":"Federico","family":"Biagi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Medical Therapy University of Pavia  Pavia Italy"},{"name":"Istituti Clinici Scientifici Maugeri IRCCS, Gastroenterology Unit of Pavia Institute  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,3]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640619844125"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2022.06.023"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2013-306578"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002075"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2017.06.037"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102021\u2010326645"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e31821a23d0"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000002497"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102036.2008.03609.x"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1515\/cclm\u20102013\u20101099"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2015.242"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535\u2010016\u20101188\u2010y"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000001773"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.22722"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.15109"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu12092736"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12664\u2010020\u201001030\u20101"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102020\u2010320913"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.16133"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.16553"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.26521"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/flgastro\u20102020\u2010101624"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/flgastro\u20102020\u2010101728"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1515\/cclm\u20102022\u20101045"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2023.07.021"},{"key":"e_1_2_10_27_1","first-page":"1","article-title":"Serum Anti\u2010Tissue Trans\u2010 Glutaminase IgA and Prediction of Duodenal Villous Atrophy in Adults With Suspected Coeliac Disease Without IgA Deficiency (Bi.A.CeD): A Multicentre, Prospective Cohort Study","volume":"1253","author":"Ciacci C.","year":"2023","journal-title":"Lancet Gastroenterology & Hepatology"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2023.12.023"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102036.2006.02967.x"},{"key":"e_1_2_10_30_1","unstructured":"K.Kaukinen K.Kurppa U.Schwab et\u00a0al. \u201cCoeliac Disease Current Care Guideline \u201d2024 https:\/\/www.kaypahoito.fi\/hoi08001."},{"key":"e_1_2_10_31_1","unstructured":"\u201cBSG Interim Guidance: COVID\u201019 Specific Non\u2010Biopsy Protocol for Those With Suspected Coeliac Disease \u201d2024 http:\/\/web.archive.org\/web\/20230131175901\/https:\/\/www.bsg.org.uk\/covid\u201019\u2010advice\/covid\u201019\u2010specific\u2010non\u2010biopsy\u2010protocol\u2010guidance\u2010for\u2010those\u2010with\u2010suspected\u2010coeliac\u2010disease\/."},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000001829"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v28.i43.6157"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2017.12.001"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102023\u2010329751"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1080\/003655201750305477"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.08.061"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(15)00537-X"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102024\u2010332071"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2013.10.010"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.17855"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2008.11.040"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2024-333110"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102023\u2010330913"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010019\u201045679\u2010x"}],"container-title":["Alimentary Pharmacology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.70129","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T12:21:27Z","timestamp":1754914887000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.70129"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,3]]},"references-count":44,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1111\/apt.70129"],"URL":"https:\/\/doi.org\/10.1111\/apt.70129","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,3]]},"assertion":[{"value":"2024-11-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}