Targeting coeliac disease serologyBMJ 2012; 345 doi: https://doi.org/10.1136/bmj.e8120 (Published 10 December 2012) Cite this as: BMJ 2012;345:e8120
All rapid responses
As a general internist who sees patient with PERSISTENT non specific symptoms, and finds a case of sprue a month, I am not in complete agreement with the authors. Celiac can present atypically, and at some point needs to be ruled in or out and for the most part, TTG can do this.
Patients with persistent medically unexplained symptoms should receive a ONE TIME TTG test, along with TSH testing etc.
The real waste, and thus opportunity for significant savings, is limiting the ability of physicians to unthinkingly repeat low yield and previously negative tests.
Competing interests: No competing interests
It seems that the increased testing in Primary Care is diagnosing at about the true incidence of Coeliac Disease. Why be disappointed at that? Coeliac disease is notoriously difficult to diagnose in Primary Care without antibody testing, and getting the correct diagnosis means spending less money in other ways.
Competing interests: Diagnosed as coeliac disease at age 35, some 38 years ago.