Test for coeliac disease first?BMJ 2010; 341 doi: https://doi.org/10.1136/bmj.c5161 (Published 02 November 2010) Cite this as: BMJ 2010;341:c5161
- David S Sanders, professor of gastroenterology1,
- Kate E Evans, clinical fellow in gastroenterology1,
- Marios Hadjivassiliou, consultant neurologist1
In their overview of investigating fatigue in primary care, Hamilton and colleagues conclude that the prevalence of fatigue in patients with coeliac disease is unknown and that coeliac serology should be a second line test.1 However, a screening study of 1200 primary care patients found that the prevalence of fatigue or being tired all the time (using primary care criteria) was 7.7% (92/1200) and the prevalence of coeliac disease in the fatigue group was 3.3% (3/92).2 Furthermore, two of the three patients reported fatigue as the sole symptom.
Coeliac disease is common in adults (1%) and frequently unrecognised; patients are often seen on many occasions in both primary and secondary care.3 The serological test is inexpensive (£20 per patient), and early detection is cost effective.4
Time for coeliac serology to be a first line test in patients with fatigue?
Cite this as: BMJ 2010;341:c5161
Competing interests: None declared.