Home blood testing for celiac disease: recommendations for management.
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


METHODS
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.


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


CONCLUSIONS
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.
Rashid
Mohsin
M
Dalhousie University, Department of Pediatrics, IWK Health Centre, 5850 University Ave, Halifax, NS B3K 6R8. mohsin.rashid@iwk.nshealth.ca
Butzner
J Decker
JD
Warren
Ralph
R
Molloy
Mavis
M
Case
Shelley
S
Zarkadas
Marion
M
Burrows
Vernon
V
Switzer
Connie
C
D001707:Biopsy, Needle; D001774:Blood Chemical Analysis; D002170:Canada; D002446:Celiac Disease / Q000097:blood* / Q000175:diagnosis / Q000178:diet therapy; D002648:Child; D055050:Diet, Gluten-Free; D016099:Endoscopy, Gastrointestinal; D005189:False Positive Reactions; D005260:Female; D005983:Glutens / Q000097:blood* / Q000378:metabolism; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012648:Self Care; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
D005983:Glutens