This is an updated guideline on coeliac disease from NICE. They have added a few extra presentations where people should be tested, but otherwise there is little that is new. See my coeliac disease review from earlier this year.
When to test.
In addition to the previous advice, they now suggest testing people with:
- Severe or persistent mouth ulcers
- Unexplained iron, B12 or folate deficiency
- First degree relatives (NICE doesn’t say that they should be symptomatic, though the BGS advised that they should be symptomatic).
You should ‘consider testing’ those with:
- metabolic bone disorders (eg osteomalacia)
- unexplained neurological symptoms (eg peripheral neuropathy or ataxia)
- unexplained subfertility or recurrent miscarriage
- dental enamel defects
- Down’s syndrome
- Turner’s syndrome