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Screening for Celiac Disease

Celiac disease is an autoimmune disease that occurs in genetically predisposed adults and children after exposure to dietary gluten. Classic celiac disease is associated with symptoms of malabsorption. However, many patients experience other symptoms such as anemia, osteoporosis, fatigue, peripheral neuropathy, ataxia, stomatitis, dermatitis herpetiformis, infertility, fetal loss or short stature. The estimated prevalence of celiac disease in the United States is 0.71% in adults and 0.76% in children. Most celiac disease in believed to be undetected despite the widespread availability of noninvasive serologic tests such as anti-tissue transglutaminase IgA antibody. Individuals with atypical or nonspecific symptoms may not be diagnosed for many years.

Screening of the general population might enable earlier detection and treatment. However, a recent review by The United States Preventive Services Task Force (USPSTF) concluded that there is insufficient evidence to support screening for celiac disease in asymptomatic persons. USPSTF found no studies on the benefits of treatment of screen-detected celiac disease compared to treatment that is initiated after clinical diagnosis.

References

US Preventive Services Task Force, Screening for Celiac Disease: US Preventive Services Task Force Recommendation Statement, JAMA 2017;317:1252-57.

Choung RS and Murray JA. The US Preventive Task Force Recommendation on Screening for Asymptomatic Celiac Disease: A Dearth of Evidence. JAMA 2017;317:1221-23.

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