Appropriate clinical use of human leukocyte antigen typing for coeliac disease: an Australasian perspective

The past decade has seen human leukocyte antigen (HLA) typing emerge as a remarkably popular test for the diagnostic work‐up of coeliac disease with high patient acceptance. Although limited in its positive predictive value for coeliac disease, the strong disease association with specific HLA genes...

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Bibliographic Details
Published in:Internal medicine journal 2015-04, Vol.45 (4), p.441-450
Main Authors: Tye-Din, J. A., Cameron, D. J. S., Daveson, A. J., Day, A. S., Dellsperger, P., Hogan, C., Newnham, E. D., Shepherd, S. J., Steele, R. H., Wienholt, L., Varney, M. D.
Format: Article
Language:English
Subjects:
Australasia - epidemiology
Celiac Disease - blood
Celiac Disease - epidemiology
Celiac Disease - genetics
coeliac disease
diagnostics
Genetic Predisposition to Disease - epidemiology
Genetic Predisposition to Disease - genetics
Histocompatibility Testing - methods
Histocompatibility Testing - utilization
HLA Antigens - blood
HLA Antigens - genetics
HLA typing
Humans
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Summary:The past decade has seen human leukocyte antigen (HLA) typing emerge as a remarkably popular test for the diagnostic work‐up of coeliac disease with high patient acceptance. Although limited in its positive predictive value for coeliac disease, the strong disease association with specific HLA genes imparts exceptional negative predictive value to HLA typing, enabling a negative result to exclude coeliac disease confidently. In response to mounting evidence that the clinical use and interpretation of HLA typing often deviates from best practice, this article outlines an evidence‐based approach to guide clinically appropriate use of HLA typing, and establishes a reporting template for pathology providers to improve communication of results.
ISSN:1444-0903
1445-5994
DOI:10.1111/imj.12716