To the Editor: We appreciate the comment by Mennini et al. The authors would have preferred a study wherein only asymptomatic patients had been investigated; however, a substantial proportion of the screen-detected patients experience unrecognized clinical symptoms (1–3), and who are really asymptomatic? Such a group may be highly selected. We agree that long-term studies are needed, as well as comparisons among children, adolescents, and adults. Meanwhile, we recommend active case finding by screening for celiac disease in at-risk groups in children. On the contrary, we do not advocate mass screening.
1. Johnston SD, Watson RGP, McMillan SA, et al. Coeliac disease detected by screening is not silent—simply unrecognized. Q J Med
2. Korponay-Szabo I, Szabados K, Pusztai J, et al. Population screening for coeliac disease in primary care by district nurses using a rapid antibody test: diagnostic accuracy and feasibility study. BMJ
3. van Koppen EJ, Schweizer JJ, Csizmadia CGDS, et al. Long-term health and quality-of-life consequences of mass-screening for childhood celiac disease: a 10-year follow-up study. Pediatrics