{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T23:06:10Z","timestamp":1781564770774,"version":"3.54.5"},"reference-count":22,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Frontline Gastroenterol"],"accepted":{"date-parts":[[2022,7,29]]},"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Emergency interim guidance from the British Society for Gastroenterology (BSG) states that a no-biopsy strategy is possible to diagnose coeliac disease (CD) in adults with elevated transglutaminase IgA antibody (TGA-IgA) levels. We aimed to determine if the suggested TGA-IgA \u226510\u00d7 ULN is safe and robust in making the diagnosis in adult patients in Scotland. We also aimed to establish if any important co-diagnoses would be missed if no biopsy was performed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method<\/jats:title>\n                  <jats:p>All positive coeliac serology results for patients aged &gt;15 years in Scotland in 2016 (Grampian 2019) were accessed. Data were collected on demographics, TGA-IgA titres, D1 sampling, histology and macroscopic findings at upper and lower gastrointestinal (GI) endoscopy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>1037\/1429 patients with positive serology proceeded to biopsy, of which 796\/1037 (76.8%) were diagnosed as CD. A total of 320\/322 (99.37%) patients with TGA-IgA \u226510\u00d7 ULN were diagnosed as CD giving the cut-off a positive predictive value of 99.38%. No significant co-pathology was found at endoscopy in these patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Our results show that a no-biopsy strategy using a cut-off of TGA-IgA \u226510\u00d7 ULN is safe to diagnose CD and that no important pathology would be missed. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition 2020 and BSG COVID-19 interim guidelines are applicable to adult patients in Scotland.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/flgastro-2022-102254","type":"journal-article","created":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T13:25:24Z","timestamp":1660224324000},"page":"97-102","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":25,"title":["No-biopsy strategy for coeliac disease is applicable in adult patients: a \u2018real-world\u2019 Scottish experience"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7449-0124","authenticated-orcid":false,"given":"Aoisha","family":"Hoyle","sequence":"first","affiliation":[{"name":"Department of Pathology, University Hospital Monklands, NHS Lanarkshire, Airdrie, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Gillett","sequence":"additional","affiliation":[{"name":"Department of Paediatric Gastroenterology, Royal Hospital for Children and Young People, NHS Lothian, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen R","family":"Gillett","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, St John's Hospital, NHS Lothian, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reuben","family":"Borg","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospital Monklands, NHS Lanarkshire, Airdrie, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Nottley","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospital Monklands, NHS Lanarkshire, Airdrie, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Farrow","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, St John's Hospital, NHS Lothian, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maha","family":"Elgoweini","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospital Crosshouse, NHS Ayrshire and Arran, Ayr, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Elhassan","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospital Crosshouse, NHS Ayrshire and Arran, Ayr, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Fletcher","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Borders General Hospital, NHS Borders, Melrose, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemma","family":"Whannel","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Dumfries and Galloway Royal Infirmary, NHS Dumfries and Galloway, Dumfries, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edel","family":"Gracie","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Dumfries and Galloway Royal Infirmary, NHS Dumfries and Galloway, Dumfries, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Morgan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Victoria Hospital, NHS Fife, Kirkcaldy, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasnain","family":"Jafferbhoy","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Victoria Hospital, NHS Fife, Kirkcaldy, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Dunbar","sequence":"additional","affiliation":[{"name":"Department of Pathology, Forth Valley Royal Hospital, NHS Forth Valley, Stirling, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon","family":"Reid","sequence":"additional","affiliation":[{"name":"Department of Pathology, Forth Valley Royal Hospital, NHS Forth Valley, Stirling, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma L","family":"Metcalfe","sequence":"additional","affiliation":[{"name":"Department of Digestive Disorders, Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graeme","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Pathology, Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, Glasgow, 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UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Furrie","sequence":"additional","affiliation":[{"name":"Department of Immunology Laboratory Services, Ninewells Hospital, NHS Tayside, Dundee, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,8,11]]},"reference":[{"key":"2025090707581288000_14.2.97.1","doi-asserted-by":"publisher","DOI":"10.1038\/nm0797-797"},{"key":"2025090707581288000_14.2.97.2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.65.8.909"},{"key":"2025090707581288000_14.2.97.3","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2013-306578"},{"key":"2025090707581288000_14.2.97.4","unstructured":"NICE . 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