{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:09:53Z","timestamp":1789016993416,"version":"build-2803163510"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The guidelines from the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) enable the diagnosis of celiac disease (CD) omitting esophagogastroduodenoscopy (EGD) in patients with high anti-Transglutaminase 2 (TG2)-IgA-antibodies. However, there is uncertainty whether this approach is safe in terms of disease outcomes for all patients. Here, we aimed to investigate the course of anti-TG2-IgA-antibodies, symptomatic response, anthropometric measurements and routine laboratory values in CD patients presenting with high anti-TG2-IgA-antibodies diagnosed with or without EGD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective case-control study in two pediatric gastroenterology centers in Giessen and Marburg. CD patients presenting with high anti-TG2-IgA-antibodies (\u226510\u00d7 upper limit of normal) were included. Data were obtained from the routine medical documentation sheet at 0, 0.5, 1 and 2 years after diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>48 patients (24 patients per group) were included. Both groups did not differ in sex or age distribution, symptom burden, comorbidities, weight and BMI z-scores or routine laboratory parameters at baseline. Decline of anti-TG2-IgA-antibodies was similar in both groups. Serological remission was achieved in 6% (without EGD) and 16% (with EGD) at 0.5 years and 26% and 41% at 1 year after diagnosis with no significant differences between the two groups. Symptom relief, weight and BMI z-scores as well as hemoglobin, ferritin and mean corpuscular volume did not differ depending on the mode of diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our data confirm that the biopsy-sparing diagnostic algorithm is associated with similar serological and clinical outcomes in pediatric CD patients. Thus, our findings support the further application and implementation of the \u201cnon-biopsy approach.\u201d<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1930734","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:30:12Z","timestamp":1789014612000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparable disease course in pediatric celiac disease with or without endoscopic confirmation at high anti-TG2-IgA-antibody titers"],"prefix":"10.3389","volume":"13","author":[{"given":"Sebastian","family":"Stricker","sequence":"first","affiliation":[{"name":"Department of General Pediatrics and Neonatology, Justus Liebig University Giessen","place":["Giessen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa Marie","family":"Sch\u00f6nfeld","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics and Neonatology, Justus Liebig University Giessen","place":["Giessen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Rommel","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics, University Children\u2019s Hospital Marburg, University of Marburg","place":["Marburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"Grunst","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics and Neonatology, Justus Liebig University Giessen","place":["Giessen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"De Laffolie","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics and Neonatology, Justus Liebig University Giessen","place":["Giessen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Rudloff","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics and Neonatology, Justus Liebig University Giessen","place":["Giessen, Germany"]},{"name":"Department of Nutritional Science, Justus Liebig University Giessen","place":["Giessen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1146\/annurev-pathmechdis-031521-032634","article-title":"The immunobiology and pathogenesis of celiac disease.","volume":"18","author":"Iversen","year":"2023","journal-title":"Annu Rev Pathol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/gutjnl-2021-326257","article-title":"Immunopathogenesis and environmental triggers in coeliac disease.","volume":"71","author":"Levescot","year":"2022","journal-title":"Gut."},{"key":"B3","doi-asserted-by":"publisher","first-page":"885","DOI":"10.1053\/j.gastro.2018.12.010","article-title":"Clinical practice update 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