Celiac Disease: Which Children Should Be Tested?

For Ritu Verma, MBChB, director of the Center for Celiac Disease and the Lustgarten Endowed Chair for Clinical Care of GI Motility Disorders at the Children's Hospital of Philadelphia in Pennsylvania, those numbers and the consequences of undiagnosed CD lead to a straightforward conclusion: "The biggest plea I have for pediatricians is to just do the panel," she told Medscape Medical News, referring to an antibody test panel that can help to determine whether a child likely has the disease.

However, other pediatric gastroenterologists, including Saeed Mohammad, MD, from Northwestern University Feinberg School of Medicine in Chicago, Illinois, feel that screening the entire population is just not feasible, and the cost of increased screening may not be justified.

"[CD] is more common in certain ethnic groups and less common in others," he told Medscape Medical News. "Unless the cost of genetic testing drastically decreases, I believe the current system of screening children with risk factors for [CD] such as diabetes, Down syndrome, or autoimmune diseases, as well as testing for celiac-specific antibodies in children whose growth is faltering [and] those who have diarrhea or chronic abdominal pain, is the most cost-effective option with the greatest sensitivity."

Moreover, he notes that children younger than 2 years should not be tested without high clinical suspicion, "and [diagnosis] should always be confirmed with endoscopy and biopsy," he continued.