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My original question was this:

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I am a celiac, diagnosed by biopsy.
My 14-year-old daughter has just got back a tissue
transglutaminase blood test reading more than 100. Is this a 
sufficient indicator for celiac disease; are there other 
tests that could be done without the risk of a biopsy?
I am thinking that a period on a gluten-free diet should
result in this tTG number dropping. Is that correct?
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Thanks to the 26 who took the trouble to reply; it was helpful.

Some respondents felt that a biopsy would not be necessary if the tTG
dropped to normal after a period gluten-free; especially in view of my own
known diagnosis.

More were in favour and reiterated that a biopsy was the 'gold standard' for
diagnosis. 
Two very practical arguments were raised in favour of biopsy:

1) Economic: In the USA it seems that this is the only diagnosis accepted by
some medical insurers. (By the way I believe it is also true in the UK if
the patient wants to take advantage of some of the free food supplements
available under the Health Service).

2) Social in view of my daughters age: Arguably the most difficult years for
compliance with a gluten-free diet are as a teenager and college student,
therefore one should not undertake the regime lightly.

Several replies led me to further research and a detailed discussion with my
specialist gastro-enterologist (who is a leading figure in this area). The
main thing we learned was that there are other conditions which can lead to
elevated tTG and therefore one could get a 'false-positive' just using the
blood test. Furthermore, some of those other conditions are more serious
(such as Crohn's disease, IBS or Aids -- thankfully none of these apply in
this case) and so a biopsy would confirm the celiac diagnosis and rule out
other concerns.

We decided to go for the biopsy. She had it today and the result was 'very
obviously celiac disease'. Now we know what to do!

Thanks again for the replies and for the comforting information and shared
experiences from other parents.  

Rob Stuart
 

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