On 2014 Aug 28, Mohammad Rostami Nejad commented:

I read with interest the paper by Rahmati et al. entitle” Correlation of Tissue Transglutaminase Antibody with Duodenal Histologic Marsh Grading” which retrospectively reviewed hospital files of 159 patients with available tTG titer and pathology reports in the gastrointestinal clinic of Firoozgar Hospital, Tehran, Iran. They reported that the mean tTG titers was significantly higher in patients with Marsh III (a-c) and more than 9 folds higher than the kit’s cut-off value. In their conclusion they said that small intestinal biopsy should always be considered in case of high clinical suspicion, regardless of the results of serologic testing and I personally not agree with this statement. New guidelines confirmed that celiac disease diagnosis in children can be made on the basis of clinical signs, serology and genetics without the need of biopsy. Therefore, in my opinion HLA typing is useful tool for this matter and can be used as diagnosis tool for celiac disease and we can avoid invasive procedures like endoscopy in these cases.

On 2014 Aug 28, Mohammad Rostami Nejad commented:

I read with interest the paper by Rahmati et al. entitle” Correlation of Tissue Transglutaminase Antibody with Duodenal Histologic Marsh Grading” which retrospectively reviewed hospital files of 159 patients with available tTG titer and pathology reports in the gastrointestinal clinic of Firoozgar Hospital, Tehran, Iran. They reported that the mean tTG titers was significantly higher in patients with Marsh III (a-c) and more than 9 folds higher than the kit’s cut-off value. In their conclusion they said that small intestinal biopsy should always be considered in case of high clinical suspicion, regardless of the results of serologic testing and I personally not agree with this statement. New guidelines confirmed that celiac disease diagnosis in children can be made on the basis of clinical signs, serology and genetics without the need of biopsy. Therefore, in my opinion HLA typing is useful tool for this matter and can be used as diagnosis tool for celiac disease and we can avoid invasive procedures like endoscopy in these cases.