Help Desk: Is an intestinal biopsy necessary when the blood work suggests celiac disease?

It depends on the antibody levels in the blood work. Symptomatic patients with serologic levels of immunoglobulin A anti-tissue transglutaminase (IgA anti-tTG) or immunoglobulin G anti-deamidated gliadin peptide antibody (IgG anti-DGP) greater than 10 times the upper limits of normal--especially if they also are positive for endomysial antibodies (EMA) and human leukocyte antigen DQ2 (HLA-DQ2 or HLA-DQ8)--may not need an intestinal biopsy to confirm the diagnosis of celiac disease.