Celiac disease screening
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Screening and case finding
There is significant debate as to the benefits of screening. Some studies suggest that early detection would decrease the risk of osteoporosis and anaemia. In contrast, a cohort studied in Cambridge suggested that people with undetected coeliac disease had a beneficial risk profile for cardiovascular disease (less overweight, lower cholesterol levels).
Due to its high sensitivity, serology has been proposed as a screening measure, because the presence of antibodies would detect previously undiagnosed cases of coeliac disease and prevent its complications in those patients. Serology may also be used to monitor adherence to diet: in those who still ingest gluten, antibody levels remain elevated.
Clinical scenarios in which screening may be justified include type 1 diabetes unexplained iron-deficiency anemia,[1][2] Down's syndrome, Turner's syndrome, irritable bowel syndrome, lupus, and autoimmune thyroid disease.[3]
Refernces
- ↑ Corazza G, Valentini R, Andreani M, D'Anchino M, Leva M, Ginaldi L, De Feudis L, Quaglino D, Gasbarrini G (1995). "Subclinical coeliac disease is a frequent cause of iron-deficiency anaemia". Scand J Gastroenterol. 30 (2): 153–6. PMID 7732338.
- ↑ Ransford R, Hayes M, Palmer M, Hall M (2002). "A controlled, prospective screening study of celiac disease presenting as iron deficiency anemia". J Clin Gastroenterol. 35 (3): 228&ndash, 33. PMID 12192198.
- ↑ Sjöberg K, Carlsson A (2004). "Screening for celiac disease can be justified in high-risk groups". Lakartidningen. 101 (48): 3912, 3915–6, 3918&ndash, 9. PMID 15631226.