The detection rate of celiac disease greatly underestimates its preval
ence. This is the result of lack of awareness of the many manifestatio
ns of the condition and the requirement for at least one small intesti
nal biopsy for diagnosis. The advent of effective serologic tests for
the condition heralds a new era of non-invasive testing. The clinical
utility and acceptance of these tests is limited by a lack of standard
ization of both the techniques used and variability of reference range
s quoted.