Reply to Dr. Panetta et al.'s letter

摘要

Panetta et al. describe that a tTG value of around 3 x upper normal limit (using an ELISA commercial kit by Liaison, DiaSorin S.p.a., Salugia, Italy) was associated with a post-test probability of celiac disease (CD) of 99% and a PPV of 100%. This is in contrast with our results, since no cut-off level of tTG (Varelisa, CelikeyTM, Phadia AB, Freiburg, Germany) was associated with a PPV of 100%. They argue that the differences between both studies could be that our patients were no symptomatic. However, this was not true. All patients in our study, also those with either Marsh 0 or Marsh 1 type lesions, had clinical symptoms who improved with a gluten-free diet (see the CD diagnosis paragraph and the results section). We and also others have described some patients with no or minor intestinal damage (Marshes 0 and 1) who.had high titres of tTG.