Antibody and genetic testing in coeliac disease

The description of a range of antibodies associated with coeliac disease has been an important development in the ability to test for this common and treatable condition non-invasively. However, the detection of these antibodies remains unstandardised and the appreciation of the clinical utility of each is evolving. In view of the advances in the diagnosis and understanding of coeliac disease, we discuss: (1) the relative advantages, disadvantages and comparative diagnostic utility of the different antibody tests including the confounding effect of selective IgA deficiency; (2) various technical aspects of these tests; (3) HLA-DQ typing as a supplementary tool to antibody testing; (4) areas of controversy resulting from insufficient or conflicting published data; and (5) potential testing strategies.