Interpreting tests for coeliac disease Tips, pitfalls and updates

Abstract

Background Coeliac disease is one of most prevalent autoimmune illnesses encountered in general practice, and GPs have a central role in its diagnosis and followup. Key challenges are improving its poor rate of detection, distinguishing it from ‘gluten sensitivity', and monitoring and optimising treatment to enhance long-term outcomes. Objective The objective of this article is to review the evidence-based use of serology, histology and genetic testing in the diagnosis and follow-up care of adults and children with coeliac disease. Discussion Recognition and testing of at-risk patients are keys to expediting the diagnosis of coeliac disease. Knowing when and how to use serology, histology, human leukocyte antigen typing and gluten challenge will increase the accuracy of both diagnosis and disease monitoring.