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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.



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