BMJ  2004;328 (7 February), doi:10.1136/bmj.328.7435.0-e

Occult coeliac disease can be detected in childhood

At age 7 years, 1% of children may have subclinical coeliac disease, but few have a gluten-free diet. In two-stage screening of 5470 children participating in the Avon longitudinal study of parents and children, Bingley and colleagues (p 322) tested for antibodies to tissue transglutaminase and then IgA antiendomysial. The 54 children who tested positive for the second enzyme were shorter and weighed less than age and geographically matched controls who had tested negative in the first stage; half had diarrhoea, and more were girls. Less than 10% of children with suspected coeliac disease were receiving a gluten-free diet. The benefit of early diagnosis of subclinical coeliac disease remains unproved, but the disease can be diagnosed in childhood.

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