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Evidence to Improve Care

Clinical Utility of Serologic Testing for Celiac Disease in Asymptomatic Patients

Ontario Health Technology Advisory Committee Recommendation

  • For children and adolescents with idiopathic short stature, the Ontario Health Technology Advisory Committee recommends that serologic testing for celiac disease (the immunoglobulin A anti-tissue transglutaminase antibody serologic test, or IgA tTG) be made available to guide a decision to introduce a gluten-free diet and evaluate its effect on growth. This is based on low-quality evidence of improved growth on a gluten-free diet in pediatric patients with idiopathic short stature and celiac disease without symptoms consistent with this disease.

Read the full OHTAC Recommendation Report

Celiac disease is a disorder of the small intestine caused by a reaction to eating gluten, a protein found in wheat, barley and rye. Abdominal pain and diarrhea are common symptoms. However, many people with celiac disease are asymptomatic: they do not show typical signs of the disease. Children with celiac disease may have stunted growth or delayed development because they cannot absorb some nutrients in food. When a child fails to grow normally but the cause is unknown, this is referred to as idiopathic short stature.

Health Quality Ontario Reviews Serologic Testing for Celiac Disease in Asymptomatic Patients

A serologic test can detect celiac disease in people with no symptoms. The test looks for elevated levels of certain antibodies in the blood that indicate an immune reaction to gluten.

Clinical Utility of Serologic Testing for Celiac Disease in Asymptomatic Patients: An Evidence-Based Analysis (PDF)
July 2011

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The Ministry of Health and Long-Term Care endorses this recommendation.

The Ministry of Health and Long-Term Care has provided the following response: The Ministry agrees with this recommendation and encourages health care professionals to adhere to it. Serological testing for celiac disease is publicly funded for in/out patients of a hospital only.

Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.


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