Many patients receive a gluten-free diet (GFD) prior to a definitive diagnosis of celiac disease. The diagnostic yield of serology can significantly decrease within a month after institution of a GFD. A recent study (VK Sarna et al. Gastroenterol 2018; 154:886-96) has identified an HLA-DQ-Gluten Tetra
mer Blood test which can accurately identify celiac disease despite the implementation of a GFD. This test quantifies HLA-DQ-gluten tetramer binding to T cells with flow cytometry. Key findings:
- For patients receiving a GFD, the sensitivity was 97% and the specificity was 95% for the diagnosis of celiac disease
- For patients not receiving a GFD, the sensitivity was 100% and the specificity was 90% for the diagnosis of celiac disease
My take: An accurate test to determine if celiac disease is present for those who have started a GFD would be quite helpful. This HLA-DQ-Gluten Tetramer blood test still needs further validation in more patient populations. This test is NOT commerically-available at this time.
Related blog posts:
- >99% Accuracy for Non-Biopsy Diagnosis of Celiac Disease
- Followup Biopsies in Pediatric Celiac Disease?
- How Slow Do Objective Markers of Celiac Change After Treatment? | gutsandgrowth
- Are followup biopsies necessary in celiac disease? Look beyond the headlines
- To biopsy or not to biopsy -that is the question (for Celiac disease)
- How Accurate is Serology at Predicting Mucosal Healing in Celiac Disease
Disclaimer: These blog posts are for educational purposes only. Specific dosing of medications (along with potential adverse effects) should be confirmed by prescribing physician. This content is not a substitute for medical advice, diagnosis or treatment provided by a qualified healthcare provider. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a condition.