Young boy holding with soft toy talking to a female doctor.

A Swedish study recommends follow up for children with a positive blood test for coeliac disease, but a negative biopsy.

When diagnosing coeliac disease in children, those who have a positive blood test, but a negative biopsy continue to have a high risk of developing the condition and should be followed for five years, a recent Swedish study found.

In 2005-2006 and 2009-2010 two school-based screenings for coeliac disease were undertaken in Sweden. About 13,000 children all 12 years of age participated.

Five years after the screening, in 2011 and 2015, all children with positive serology were invited back for a clinical follow-up. The researchers found that about a third of the children who had positive blood tests but negative biopsies in their initial screening, developed coeliac disease within five years.

“In this study, we had the possibility to follow 39 cases of potential coeliac disease for five years and found that about one third developed coeliac disease within this period,” said the authors of the study.

Fortunately, children who originally had a negative coeliac disease blood test had a very low risk of being diagnosed in the five-year follow-up period.

“Potential coeliac disease requires follow-up because of the high risk of conversion to disease with enteropathy. The risk of receiving a clinical diagnosis within five years from a screening is very low indicating that a possible repeated screening can wait longer than this,” conclude the authors of the study.