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Home blood testing for celiac disease

Recommendations for management

J. Decker Butzner, MD FRCPC
Professor in the Department of Pediatrics at the University of Calgary in Alberta

Ralph Warren, MD FRCPC
Staff gastroenterologist in the Department of Medicine at St Michael’s Hospital at the University of Toronto in Ontario

Mavis Molloy, MAEd
Clinical Dietitian at Kelowna General Hospital in British Columbia

Shelley Case
Consulting dietitian in Regina, Sask

Marion Zarkadas, MSc
Member of the Professional Advisory Board of the Canadian Celiac Association

Vernon Burrows, PhD
Research Scientist Emeritus at Agriculture and Agri-Food Canada in Ottawa, Ont

Connie Switzer, MD FRCPC
Clinical Professor of Medicine in the Department of Medicine at the University of Alberta in Edmonton. All authors are members of the Professional Advisory Board of the Canadian Celiac Association

Correspondence: Dr M. Rashid, Dalhousie University, Department of Pediatrics, IWK Health Centre, 5850 University Ave, Halifax, NS B3K 6R8; telephone 902 470-8746; fax 902 470-7249; e-mailmohsin.rashid{at}iwk.nshealth.ca

OBJECTIVE To provide recommendations for the management of patients who inquire about the Health Canada–approved, self-administered home blood tests for celiac disease or who present with positive test results after using the self-testing kit

SOURCES OF INFORMATION PubMed and the Cochrane Database of Systematic Reviews were searched from January 1985 to April 2008, using the subject headings diagnosis of celiac disease and management or treatment of celiac disease. Guidelines for serologic testing and confirmation of diagnosis of celiac disease by the American Gastroenterological Association and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition are used in this review. Level 1 evidence was used.

MAIN MESSAGE Although blood tests are helpful for screening purposes, the confirmatory test for celiac disease is a small intestinal biopsy.

CONCLUSION Patients whose blood tests for celiac disease provide positive results should have endoscopic small intestinal biopsies to confirm the diagnosis before starting a gluten-free diet.

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