Copyright ©The Author(s) 2015.
World J Gastroenterol. Jun 21, 2015; 21(23): 7110-7119
Published online Jun 21, 2015. doi: 10.3748/wjg.v21.i23.7110
Table 1 Diagnostic tests for gluten related disorders
SerologyGeneticHistologySkin testsChallenges
Celiac diseaseAnti transglutaminase IgA plus IgA dosage are used as screening test Anti endomysium as confirmatory testHLA typing is useful to exclude celiac diseasePresence of duodenal atrophy is considered the gold standard in adulthoodNot usedGluten challenge is used in case of genetically predisposed patients following a gluten free diet
Wheat allergyThe research of IgE against the suspected allergens is sensitiveNot usedNot strictly indicatedSkin reactions against allergens have a low sensitivity especially in case of wheat due to the absence of specific components in commercial reagentsChallenges with the suspected allergens are still considered the gold standard although potentially dangerous for the patient
Non celiac gluten sensitivityAnti gliadin IgG positive in 50% of casesNot usedNot strictly indicated; a mild duodenal intraepithelial lymphocytosis is possible in up to 50% of suspected casesNot usedDouble blind challenge with gluten could be considered the gold standard for diagnosis