In a very recent and welcome article, Schiepatti et al address a challenging field of gastroenterology.1 Whereas the diagnosis of coeliac disease in most cases is simple, although overlooked, there are other circumstances where this is much more difficult. There are also several other causes of villous atrophy, the hallmark of coeliac disease, that may be considered, although coeliac disease is by far the most frequent cause of those pathological findings. The author group shall be acknowledged for their effort. The critical question, however, remains: are the clinicians better helped with the current publication?

The group of investigators were recruited during the most recent International Coeliac Disease Symposium in Paris, France in the autumn of 2019. These symposia have regularly been arranged since its first start in London in 1970. These symposia have, during recent years, repeatedly been followed by guideline and statement papers, most of which have been published in Gut.2–5 This time, the authors gathered a group of world-leading experts on coeliac disease, but, unfortunately, no (molecular) pathologists and no immunologists on board. In addition, there were wide regions of the world not represented. …