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Home blood testing for celiac disease: recommendations for management
Mohsin Rashid1, J Decker Butzner, Ralph Warren
1Dalhousie University, Department of Pediatrics, IWK Health Centre, 5850 University Ave, Halifax, NS B3K 6R8. mohsin.rashid@iwk.nshealth.ca
Canadian Family Physician Medecin De Famille Canadien
|February 18, 2009
Summary
Home blood tests can screen for celiac disease, but positive results require a confirmatory small intestinal biopsy. Confirm diagnosis before starting a gluten-free diet.
Area of Science:
- Gastroenterology
- Immunology
- Diagnostic Medicine
Background:
- Increasing availability of self-administered home blood tests for celiac disease.
- Need for clear management guidelines for positive home test results.
Purpose of the Study:
- Provide recommendations for managing patients using home celiac disease blood tests.
- Outline diagnostic pathways following positive self-test results.
Main Methods:
- Systematic literature search of PubMed and Cochrane Database (1985-2008).
- Inclusion of guidelines from American Gastroenterological Association and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition.
- Focus on Level 1 evidence for diagnostic accuracy.
Main Results:
- Home blood tests serve as a screening tool for celiac disease.
- A small intestinal biopsy is the definitive confirmatory test for celiac disease.
Conclusions:
- Positive blood test results for celiac disease necessitate further confirmation.
- Endoscopic small intestinal biopsy is recommended to confirm celiac disease diagnosis prior to dietary changes.
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