Intended for healthcare professionals

Rapid response to:

Clinical Review

Investigation and management of unintentional weight loss in older adults

BMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d1732 (Published 29 March 2011) Cite this as: BMJ 2011;342:d1732

Rapid Response:

Screening for coeliac disease in older patients presenting with weight loss.

Jenna McMinn et al should be commended on their excellent article on
the investigation and management of unintentional weight loss in older
patients.(1)
However, we feel that screening for coeliac disease in older patients with
unintentional weight loss has been wrongly overlooked as part of their
recommended baseline tests.

Coeliac disease remains underdiagnosed in adults. The prevalence in the
general populations is around 1% and delay in diagnosis has been reported
to range from 4.5 years to 9 years.(2)

Symptoms of coeliac disease in adults are varied and can include
unintentional weight loss alone. Serological testing for IgA
transglutaminase antibodies are highly specific and approach 100%
accuracy.(3) This makes it a simple and cost effective test and should be
part of baseline tests for any older patient presenting with unintentional
weight loss.

References

(1)McMinn J et al. Investigation and management of unintentional
weight loss in older adults.BMJ 2011;342:d1732

(2)Hopper AD et al.Adult coeliac disease.BMJ 2007;335:558-62

(3)Celiac Disease.Green PHR,Cellier C.N Engl J Med 2007;357:1731-43

Competing interests: No competing interests

19 April 2011
Ruchit Sood
SpR Gastroenterology
Deven Vani consultant gastroenterologist, Lionel Gracey-Whitman consultant gastroenterologist
Pinderfields General Hospital