In a commentary regarding applicability of the new ESPGHAN guidelines for diagnosing celiac disease in children from resource limited countries [14], it has been suggested that positive HLA-DQ2/DQ8 serotype and EMA are necessary in order to apply the ESPGHAN guidelines for serological diagnosis of CD, and that CD should not be diagnosed on the basis of a single high tTG-titre. Here, TGM2 is linked to Cowden disease.