Open Access: Evaluating for Celiac Disease in Patients on a Gluten-Free Diet: A Practical Approach

Algorithm -Figure 2:

Figure 3 lists the content of several common foods -some noted below

While gluten exposure increases the diagnostic yield of currently available tests, there are novel tests being developed “which may aid in the diagnosis of CeD regardless of diet, with a particular focus on immune-based assays. One such innovation involves the use of tetramer-based assays, which enable the direct detection of gluten-specific T cells in the blood. These tetramers, designed to bind to HLA-DQ2 molecules, can help identify T cells that have been activated by gluten exposure. This presents a highly specific immune marker for CeD. Even for those on a GFD, sensitivity (97%) and specificity (95%) have been impressive.”

My take: This article provides practical advice for evaluating whether celiac disease is present in those already consuming a GFD.

Related blog posts:

• Dr. Arun Singh: Tips and Tricks to Managing Celiac Disease (includes links to more than 20 blog posts)
• How a Gluten Challenge Could Change
• Eliminating Gluten Challenge for the Diagnosis of Celiac Disease
• Is a Gluten-Free Diet a Healthy Diet for Those without Celiac Disease?
• Gluten-Free Diet –Role in IBS?
• Best Screening For Celiac At All Ages
• 2023 ACG Celiac Guidelines for Adult and Children
• Study May Indicate Biologic Basis for Brain Fog in Persons with Celiac Disease

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