[How to approach screening for celiac disease in 2008]

Due to its high prevalence, celiac disease is a major health problem. Because of the long-term complications and difficulty of diagnosing this disease, the need for population-based screening has been raised. Serological methods for detection of celiac disease include antiendomysial and antitransglutaminase antibody detection, which has high sensitivity and specificity (nearly 100%) in forms with atrophy and low sensitivity and specificity (between 15 and 30%) in patients with minimal lesions, thus posing diagnostic difficulties in this group of individuals. The risk of late complications is unknown in this group of patients with lymphocytic enteritis. However, this group may be just as symptomatic as patients with atrophy and consequently would also benefit from a gluten-free diet. Systematic screening allows a greater number of patients with gluten-sensitive enteropathy to be detected. However, there are insufficient data to be able to evaluate the economic and social impact of systematic screening.