Home blood testing for celiac disease

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.