Table 1.

Who should be tested for CD [9].

High Risk Patients Routinely Test for CD: Consider Endoscopy even if Serology Negative	Medium Risk Patients Consider CD Serologic Testing: CD Sufficiently Excluded if Serology Negative	Low Risk Patients Consider testing if refractory to standard therapy or other clinically unusual features: CD sufficiently excluded if serology negative
(1) Chronic gastrointestinal symptoms with a family history of celiac disease or a personal history of autoimmune disease or IgA deficiency (2) Biopsy proven dermatitis herpetiformis (3) Chronic diarrhea (4) Failure to thrive in children (5) Iron deficiency anemia refractory to oral supplementation	(1) Irritable bowel syndrome (2) Elevated liver function tests (3) Iron deficiency anemia (4) Fatigue/lethargy (5) Chronic gastrointestinal symptoms without a family history of celiac disease or a personal history of autoimmune disease (6) Peripheral neuropathy (7) Ataxia (8) Dental enamel defects (9) Recurrent aphthous ulcerations (10) Hyposplenism (11) Fertility abnormalities (12) Down’s or Turner’s syndrome (13) Known IgA deficiency (14) Microscopic colitis	(1) Osteopenia/osteoporosis (2) Fibromyalgia (3) Chronic Fatigue Syndrome (4) Heartburn/GERD (5) Acute or chronic pancreatitis (6) Alopecia (7) Myalgias/Arthralgias (8) Autoimmune liver disease (9) Personal history of autoimmune disease or connective tissue disease without ongoing unexplained symptoms (10) Skin lesions other than dermatitis herpetiformis (11) Headaches including migraines (12) Mood disorders (13) Attention deficit disorder/cognitive impairment (14) Epilepsy (15) Restless leg syndrome

Reproduced with permission from Leffler D.A. Celiac disease diagnosis and management: A 46-year-old woman with anemia. JAMA 2011, 306, 1582–1592 [9].