Digestive Diseases and Sciences

, Volume 50, Issue 3, pp 587–592 | Cite as

Case-Finding for Adult Celiac Disease in Patients with Reduced Bone Mineral Density

  • David S. Sanders
  • Dina Patel
  • Fozia B. Khan
  • Rachel H. Westbrook
  • Chloe V. Webber
  • Anthony Milford-Ward
  • Eugene V. McCloskey


The aim of this study was to assess the value of case-finding for unrecognized adult celiac disease (CD) in patients with reduced bone mineral density (BMD), verified by dual-energy X-ray absorptiometry (DXA). Patients attending for a DXA scan were investigated for CD using immunoglobulins, IgG/IgA antigliadin antibodies (AGA), and endomysial antibodies (EMA). All patients with a positive IgA AGA, EMA, or only IgG AGA in the presence of IgA deficiency had a small bowel biopsy. There were 12 cases of CD (12/978), a prevalence of 1.2% for the whole cohort. The prevalence of CD was 0.7% (2/304) for those with a normal BMD, 1.2% (5/431) for patients with osteopenia, and 2.1% (5/243) for patients with osteoporosis. Direct questioning revealed that all patients with unrecognized CD had subtle gastrointestinal symptoms or a history of anemia. Excluding patients without these symptoms would give a prevalence of 3.9% for osteoporosis (5/127) and 2.6% for osteopenia (5/191). This study suggests that there is no value of unselected case-finding for CD in patients with a reduced BMD. However, a targeted case-finding approach may be more valid and cost-effective with the initial selection of patients who should be investigated for CD based on questioning about gastrointestinal symptoms or anemia.


celiac disease prevalence bone mineral density case-finding dual-energy X-ray absorptiometry. 


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Copyright information

© Springer Science + Business Media, Inc. 2005

Authors and Affiliations

  • David S. Sanders
    • 1
    • 4
  • Dina Patel
    • 3
  • Fozia B. Khan
    • 1
  • Rachel H. Westbrook
    • 1
  • Chloe V. Webber
    • 1
  • Anthony Milford-Ward
    • 3
  • Eugene V. McCloskey
    • 2
  1. 1.Gastroenterology and Liver UnitNorthern General HospitalSheffieldUK
  2. 2.Metabolic Bone Unit, Royal Hallamshire HospitalNorthern General HospitalSheffieldUK
  3. 3.Supra-Regional Protein Reference UnitNorthern General HospitalSheffieldUK
  4. 4.SheffieldUK

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