Article Text

Download PDFPDF
Authors’ response: British Society of Gastroenterology guidelines on the diagnosis and management of coeliac disease
  1. Andrew S Austin1,
  2. Julia M Forsyth2,
  3. Peter G Hill3,
  4. Geoffrey K T Holmes3
  1. 1 Derby Digestive Diseases Centre, Royal Derby Hospital, Derby, UK
  2. 2 Department of Pathology, Royal Derby Hospital, Derby, UK
  3. 3 Royal Derby Hospital, Derby, UK
  1. Correspondence to Dr Andrew S Austin, Derby Digestive Diseases Centre, Royal Derby Hospital, Derby DE22 3NE, UK; andrew.austin1{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

We were interested to read the reply to our letter1 by Kurien et al2 but consider that they have not made the case for performing a small bowel biopsy in all patients with coeliac disease (CD) to establish the diagnosis. Further support for our view that duodenal biopsy can be avoided in some patients was recently provided by Tortora et al.3 Kurien et al have also responded to that paper and their two responses suggest a fundamental misunderstanding of the data on which a ‘biopsy avoidance strategy’ is based.

It is incorrect of them to assert that their 2008 study4 ‘clearly refutes’ our suggestion. First, it is essential to use an assay with high specificity (>97%) but the IgA-class antitissue transglutaminase …

View Full Text


  • Contributors All authors were involved in the drafting of this letter and approved the final version for submission.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.