Serum anti-tissue transglutaminase IgA (tTG-IgA) levels can reliably diagnose celiac disease without the need for a diagnostic bowel biopsy in adults without IgA deficiency.
This approach has a high positive predictive value (95.9%) and sensitivity (98%) when serum tTG-IgA concentrations are greater than 10 times the upper limit of normal.
The authors of the study published in the Lancet Gastroenterology and Hepatology recommended a No-Biopsy approach in patients without IgA deficiency and highly positive celiac serology