When to offer testing (test) for coeliac disease

• Offer serological testing for coeliac disease to:
  
  
  • people with any of the following:
    • persistent unexplained abdominal or gastrointestinal symptoms
      
      
    • faltering growth prolonged fatigue
      
      
    • unexpected weight loss
      
      
    • severe or persistent mouth ulcers
      
      
    • unexplained iron, vitamin B12 or folate deficiency
      
      
    • type 1 diabetes, at diagnosis
      
      
    • autoimmune thyroid disease, at diagnosis
      
      
    • irritable bowel syndrome (in adults)
      
      
  • first-degree relatives of people with coeliac disease
    
    
• Consider serological testing for coeliac disease in people with any of the following:
  
  
  • metabolic bone disorder (reduced bone mineral density or osteomalacia)
    
    
  • unexplained neurological symptoms (particularly peripheral neuropathy or ataxia)
    
    
  • unexplained subfertility or recurrent miscarriage
    
    
  • persistently raised liver enzymes with unknown cause
    
    
  • dental enamel defects
    
    
  • Down's syndrome
    
    
  • Turner syndrome

Healthcare professionals should have a low threshold for re-testing people identified in recommendations if they develop any symptoms consistent with coeliac disease

Reference:

• NICE (September 2015). Coeliac disease: recognition, assessment Coeliac disease: recognition, assessment and management.