22 Diseases or Conditions that Require Celiac Disease Screening

Celiac.com 08/21/2020 - So who, exactly, should be screened for celiac disease? The guidelines and parameters for who and when to test for celiac disease change as new data becomes available. Based on recent study data, and recommendations by the three major celiac disease organizations, many doctors advise celiac screening for patients with any of the following twenty-two conditions or diseases:

Anemia

Unexplained iron, vitamin B12 or folate deficiency. A 2014 study showed that celiac disease is common in people with unexplained anemia. The study team recommends celiac screening for anyone with unexplained iron-deficient anemia, while the The U.K. National Institute for Health and Care Excellence recommend celiac screening for anyone with unexplained vitamin B-12 or folate deficiency.

Aphthous stomatitis

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People with severe or persistent mouth ulcers (canker sores) should get screened for celiac disease. A 2020 study confirms that doctors should consider celiac disease in patients with severe or recurrent aphthous stomatitis.

Autism

People with autism have celiac disease at rates almost 20 times higher than in those without autism, reported lead investigator Daniel Karb, MD, a second-year resident at University Hospitals Case Medical Center in Cleveland. As such, many doctors now recommend celiac screening for people with autism.

Autoimmune Thyroid Disease

The The U.K. National Institute for Health and Care Excellence recommends celiac screening for anyone with thyroid disease. 

Dental Enamel Defects

Certain types of dental enamel defects can be strong indicators of celiac disease. A 2018 study shows that non-specific tooth wear and enamel defects can be strong indications of celiac disease.

Dermatitis Herpetiformis (DH)

People with dermatitis herpetiformis, aka DH, or Duhring’s disease, suffer from a herpes-like rash. About 10% to 15% of people with celiac disease have DH.  Anyone with DH should be checked for celiac disease. Most people with DH see major improvements on a gluten-free diet.

Failure to Thrive and Persistent Diarrhea in Children

The North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and The American College of Gastroenterology recommends celiac screening for children with failure to thrive, especially with persistent diarrhea.

Unexplained Fatigue

Unexplained fatigue. People with persistent unexplained fatigue should consider screening for celiac disease, according to the U.K. National Institute for Health and Care Excellence.

GERD

Some studies show no link between Gastroesophageal Reflux Disease (GERD) and celiac disease. A 2015 study showed that celiac disease not a big factor in gastro-esophageal reflux disease. But a 2020 study showed that non-celiac gluten sensitivity is common in patients with refractory functional dyspepsia. Many doctors recommend celiac disease screening for patients with GERD. 

High Transaminase Levels

High transaminase levels can be an indication of liver damage, heart damage, and are common in people with celiac disease. 

Down syndrome

A 2020 study shows that people with Down syndrome have celiac disease at up to twenty times the rate of the general population. Celiac disease screening is important for anyone with Down syndrome.

IgA Deficiency

The North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition recommends testing for celiac disease in asymptomatic children who have conditions associated with celiac disease, including selective IgA deficiency.

Irritable Bowel Syndrome in Adults

Adults with irritable bowel syndrome should be screened for celiac disease, according to the The U.K. National Institute for Health and Care Excellence.

Persistent Unexplained Elevated Liver Enzymes

The U.K. National Institute for Health and Care Excellence recommends celiac screening for people with persistently elevated liver enzymes with unknown cause.

Recurrent Miscarriages

The U.K. National Institute for Health and Care Excellence recommends celiac screening for women who experience recurrent miscarriages.

Immediate Relatives of Anyone with Celiac Disease

First-degree relatives (mother, father, brother, sister, son, daughter) of anyone with celiac disease should get a celiac screen, according to Mayo Clinic.

Short Stature

A 2020 study shows that biopsy confirmed celiac disease affects about 1 in 14 patients with all‐cause short stature, and 1 in 9 patients with idiopathic short stature. Based on these results, doctors are recommending screening all patients with short stature should be screened for celiac disease.

Thyroiditis

Thyroiditis is an auto-immune condition associated with celiac disease. The North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) recommends celiac disease screening in children who have thyroiditis.

Turner syndrome

Turner syndrome is associated with celiac disease. The North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) recommends celiac disease screening in children who have Turner syndrome.
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Type 1 diabetes

More than 20% of people with Type 1 diabetes have celiac disease. The North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) recommends celiac disease screening in children who have Type 1 diabetes.

Unexplained Infertility

Women with infertility face higher rates of celiac disease. Many doctors do not screen for celiac disease in these women. However, for women experiencing unexplained infertility, especially repeatedly, a celiac disease screen is probably a good idea.

Unexplained Neuropathy

Patients with unexplained neuropathy, or small fiber neuropathy should be screened for celiac disease and gluten-sensitivity, according to researchers.

Unexplained Weight Loss

According to the U.K. National Institute for Health and Care Excellence, people who suffer from unexplained weight loss should be screened for celiac disease.

Consider Celiac Screening for These Common Physical Complaints

People with any of the ten most common complaints of celiac patients, or any of the below conditions that are associated with celiac disease, along with any obvious signs of celiac disease, including persistent diarrhea or stomach upset, should consider celiac screening. These include:

• Anemia
• Alternating bowel habit
• Bloating
• Constipation
• Cryptogenic hypertransaminasemia
• Diarrhea
• Gastroesophageal reflux disease
• Osteopenia/Osteoporosis
• Recurrent miscarriages
• Unexplained Infertility

Other Conditions Associated with Celiac Disease

The following conditions are not included in the official celiac screening recommendations by the above organizations. However, anyone with any of the following conditions, along with any obvious signs of celiac disease, including persistent diarrhea or stomach upset, should consider celiac screening. These include:

• Addisons Disease
• Alopecia
• Anxiety and Depression
• Ataxia
• Attention Deficit Disorder/ADHD
• Autism
• Autoimmune Hepatitis / Chronic Active Hepatitis
• Bird Fanciers Lung
• Brain White-Matter Lesions
• Cerebellar Atrophy
• Chronic Fatigue Syndrome (myalgic encephalomyelitis or ME, PVS, post viral fatigue syndrome or PVFS)
• Crohns Disease
• Congenital Heart Disease
• Cystic Fibrosis
• Dental-Enamel Hypoplasia
• Dyspepsia
• Epilepsy (with or without cerebral calcification)
• Farmers Lung
• Fibromyalgia and Celiac Disease
• Fibrosing Alveolitis
• Follicular Keratosis
• Gall Bladder Disease
• Gastroparesis
• Head Aches (Migraine)
• IBD - Irritable Bowel Disease
• Impotency
• Infertility
• Inflammatory Bowel Disease
• Lung Cavities
• Multiple Sclerosis and Celiac Disease
• Myasthenia Gravis
• Pancreatic Disorders / Exocrine Pancreatic Insufficiency
• Peripheral Neuropathy
• Polymyositis
• Polyneuropathy
• Primary Biliary Cirrhosis
• Pulmonary Hemosiderosis
• Recurrent Pericarditis
• Sarcoidosis
• Schizophrenia / Mental Problems and Celiac Disease
• Scleroderma
• Short Stature, Delayed Puberty
• Small-Intestinal Adenocarcinomas
• Spontaneous Abortion and Fetal Growth Retardation
• Systemic Lupus Erythematosus
• Thrombocytosis (Hyposplenism)
• Thrombocytopenic Purpura (ITP)
• Thyrotoxicosis
• Vasculitis
• Vitamin K Deficiency

Celiac Disease Screening Recommendations by Organization

• The American College of Gastroenterology
• The North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN)
• The U.K. National Institute for Health and Care Excellence