Seroprevalence vs Biopsy Prevalence of Celiac Disease: A Bird’s Eye View

Celiac disease (CD) is an autoimmune disorder precipitated generally in genetically susceptible individuals by the ingestion of gluten and is becoming a major communal health problem throughout the globe. Initially the disease was reported in few of the countries specifically in predominant Caucasian populations, but now a day it is being reported from almost all parts of the world. Simplification of the diagnostic criteria and widespread use of serologic tests have made it possible to estimate the prevalence of CD in the general population. But the exact global prevalence of the celiac disease is quite ambiguous due to the fact that when the disease is diagnosed with tTG test it is generally not confirmed with the biopsy examinations whereas, diagnosis should be based on the combination of both as per current guidelines on diagnosis of CD. The seropositive based (anti-tissue transglutaminase and/or anti-endomysial antibodies) data shows a high global prevalence of 1.4% whereas biopsy-confirmation based data shows a global prevalence of only 0.7%. Although prevalence of celiac disease varies with respect to sex, age, and location etc. but its accurate prevalence is not being reported due to various reasons. At the same time, a classified data of prevalence of the celiac disease based on multiple factors does not exist. This manuscript intends to highlight various underlying reasons responsible for generating vague prevalence data worldwide along with an awareness note regarding practical implications of diagnostic modalities.