Recognition and assessment of coeliac disease in children and adults: summary of NICE guidance

Coeliac disease is an autoimmune condition that can be diagnosed at any age. Although it has been traditionally associated with mainly gastrointestinal signs and symptoms, its non-gastrointestinal features have been increasingly recognised. Given its varied clinical manifestations and the historical belief that it is relatively uncommon,1 2 concern has been raised that coeliac disease—and its possible long term consequences—is being underdiagnosed. It has also been shown to be more prevalent in people with other autoimmune conditions.3 This article summarises the most recent recommendations from the National Institute for Health and Clinical Excellence (NICE) on the recognition and assessment of coeliac disease.4 NICE recommendations are based on systematic reviews of best available evidence. When minimal evidence is available, recommendations are based on the Guideline Development Group’s experience and opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets. ### Who should be offered serological testing for coeliac disease? [Based on moderate quality evidence from cohort studies]

[1]  A. Dalgleish Adult coeliac disease , 1996, The Lancet.

[2]  J. Warner,et al.  NICE clinical guideline 86. Coeliac disease: recognition and assessment of coeliac disease , 2010, Archives of Disease in Childhood.

[3]  G. Corazza,et al.  The clinical pattern of subclinical/silent celiac disease: an analysis on 1026 consecutive cases Figure 1 , 1999, American Journal of Gastroenterology.

[4]  P. Howdle,et al.  Recent advances in coeliac disease , 2009, Current opinion in gastroenterology.