Tailored Testing for Celiac Disease
Authors: Shadi Rashtak
Journal: Annals of Internal Medicine (2007)

Editorials4 September 2007Tailored Testing for Celiac DiseaseShadi Rashtak, MD and Joseph A. Murray, MDShadi Rashtak, MDFrom Mayo Clinic College of Medicine, Rochester, MN 55905. and Joseph A. Murray, MDFrom Mayo Clinic College of Medicine, Rochester, MN 55905.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-147-5-200709040-00009 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Celiac disease is a gluten-sensitive enteropathy occurring in genetically susceptible individuals and affecting almost 1% of the population. The small-intestine biopsy, currently the gold standard test, is a rather invasive and expensive test to serve as the initial step in the diagnosis of celiac disease (1, 2). Therefore, current guidelines recommend serologic testing for autoantibodies against tissue transglutaminase (TGA) or endomysium (EMA) as the first step (1, 2). Most studies have reported excellent sensitivity and specificity for these tests (3, 4), but some studies have reported unsatisfactory sensitivity, particularly among patients with mild intestinal damage (5, 6). The HLA types ...References1. Hill ID, Dirks MH, Liptak GS, Colletti RB, Fasano A, Guandalini S, et al. Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr. 2005;40:1-19. [PMID: 15625418] CrossrefMedlineGoogle Scholar2. Rostom A, Murray JA, Kagnoff MF. American Gastroenterological Association (AGA) Institute technical review on the diagnosis and management of celiac disease. Gastroenterology. 2006;131:1981-2002. [PMID: 17087937] CrossrefMedlineGoogle Scholar3. Carroccio A, Vitale G, Di Prima L, Chifari N, Napoli S, La Russa C, et al. 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[PMID: 12651074] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Mayo Clinic College of Medicine, Rochester, MN 55905.Grant Support: Dr. Murray is supported in part by National Institutes of Health grants DK071003 and DK 57892 and by the Mayo Foundation.Disclosures: Dr. Murray has consulted for, has received honoraria from, and is on the Scientific Advisory Board of Alvine Inc., which is developing treatments for celiac disease. He is also an employee of the Mayo Clinic, which has received a grant as part of a multicenter study from Alba Inc. Alba Inc. is also developing treatments for celiac disease. The topic of this paper, however, does not directly relate to the products being developed or tested by either company.Corresponding Author: Joseph A. Murray, MD, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905; e-mail, mailto: murray.[email protected]edu.Current Author Addresses: Drs. Rashtak and Murray: Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAccuracy of Serologic Tests and HLA-DQ Typing for Diagnosing Celiac Disease Muhammed Hadithi , B. Mary E. von Blomberg , J. Bart A. Crusius , Elisabeth Bloemena , Pieter J. Kostense , Jos W.R. Meijer , Chris J.J. Mulder , Coen D.A. Stehouwer , and Amado S. 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