BUDAPEST, HUNGARY — Serologic testing can be a useful adjunct to intestinal mucosal biopsy in the diagnosis of celiac disease under certain conditions, said Pekka Collin, M.D., a gastroenterologist at the University of Tampere (Finland).
Antitissue transglutaminase IgA antibody and serum antiendomysial IgA antibody tests are sensitive and specific, Dr. Collin said at the 4th International Congress on Autoimmunity.
“What we do now in clinical practice is, we use serum screening tests for all kinds of risk groups,” he said. The most typical risk group is first-degree relatives of a patient with celiac disease, for whom the risk of having the disease is about 10%–15%. Patients with other autoimmune conditions make up another risk group, with a roughly 5% risk of also having celiac disease.
“Then we also take antibodies—and subsequently, biopsies, in positive cases—when a patient has atypical symptoms,” said Dr. Collin, a member of the Celiac Disease Study Group at the university. These atypical symptoms include infertility, osteoporosis, and neurologic symptoms, such as polyneuropathy, ataxia, epilepsy, and posterior cerebral calcification.
By focusing on patients with a high index of suspicion based on clinical symptoms and by screening patients in high-risk groups, Dr. Collin finds a prevalence of 0.7% for celiac disease among his patients. It's estimated that the true prevalence of the disease among the general population is 1%.