Changing patterns of coeliac serology requests

Area of Science:

• Gastroenterology
• Clinical Diagnostics
• Epidemiology

Background:

• Accurate serological tests are crucial for diagnosing coeliac disease.
• Understanding trends in coeliac serology is essential for optimizing diagnostic pathways.

Purpose of the Study:

• To analyze coeliac serology request volumes and origins over ten years.
• To evaluate positivity rates and subsequent confirmation of coeliac disease via duodenal biopsy.

Main Methods:

• Retrospective analysis of laboratory databases from 1997-2006.
• Categorization of request origins (gastroenterology, general practice, paediatrics, etc.).
• Exclusion of duplicate requests to ensure data accuracy.

Main Results:

• Total requests rose from 302 to 1826 annually; 66% were in females.
• General practitioner requests surged from 3.3% to 52%; positivity rates dropped from 5.7% to 2.6%.
• Biopsy confirmation of coeliac disease in seropositive patients remained high (91%), though biopsy rates slightly decreased.

Conclusions:

• General practitioner requests for coeliac serology have markedly increased.
• Diminishing positivity rates suggest testing at lower symptom thresholds.
• A significant proportion of positive serology results are not histologically confirmed, highlighting potential over-testing or diagnostic challenges.