Celiac Disease Comprehensive Panel
Benefits
| • | Assists physicians in differentiating celiac disease from irritable bowel syndrome |
| • | Enables early detection of gluten sensitivity, which may help avoid progression of celiac disease, particularly in children |
| • | Useful in monitoring adherence to gluten-free diet |
Panel Comprises:
| • | Tissue Transglutaminase (tTG) Antibody, IgA |
| • | Gliadin Antibody, IgA |
| • | Total IgA |
| • | Endomysial Antibody (EMA) Screen, IgA- performed (at additional charge) when the anti-tTG IgA is positive |
| • | EMA Titer-performed (at additional charge) when the EMA screen is positive |
| • | tTG Antibody, IgG-performed (at additional charge) when total IgA is low |
Clinical Summary
Celiac disease is caused by an immune response to gluten in genetically susceptible individuals. Patients may develop partial to complete villous atrophy of the small intestine, crypt hyperplasia, and lymphocytic infiltration of the epithelium and lamina propria.
This disease is more common than once thought, affecting as many as 1 in 133 "not-at-risk" Americans (ie, those without family history or gastrointestinal symptoms); rates are even higher among first- and second-degree relatives of patients.1
Untreated, celiac disease may be accompanied by progression of villous atrophy and development of other autoimmune diseases (eg, thyroid disease and insulindependent diabetes mellitus), osteoporosis, and neoplasia, including T-cell lymphoma and adenocarcinoma of the small intestine.
Diagnosis is based on biopsy of the small intestine, but serologic assays help identify patients who require this invasive procedure. Tissue transglutaminase (tTG; IgA) antibody is an excellent first-line marker, with high sensitivity and specificity in untreated individuals.2 The endomysial antibody (EMA; IgA) assay has high specificity for celiac disease and is used to confirm positive IgA anti-tTG results. Although this panel tests for EMA only when anti-tTG (IgA) results are positive, EMA testing can be ordered separately if the IgA anti-tTG result is negative but clinical suspicion remains high. Some patients with limited villous atrophy have been reported to lack EMA and tTG antibodies; testing for IgA antigliadin antibody (AGA) may help detect celiac disease in such patients.3 Total serum IgA is measured to identify selective IgA deficiency, present in about 2% to 10% of celiac disease patients. Such patients would have negative results on IgA anti-tTG and EMA assays but may have positive IgG anti-tTG results.
Because levels of anti-tTG and EMA tend to wane in the absence of gluten ingestion, these markers are useful to monitor adherence to a gluten-free diet.
Leaders in Digestive Diseases
Quest Diagnostics offers extensive clinical and pathology testing services to assist physicians in the diagnosis and management of a broad spectrum of gastroenterological disorders, including:
| • | Inflammatory bowel disease |
| • | Celiac disease and gluten sensitivity |
| • | Colorectal and other gastrointestinal cancers |
| • | Liver disease and hepatitis |
| • | Peptic ulcer disease (H pylori) |
Specimen Requirements
| • | 5 mL serum; 2 mL minimum |
| • | Ship refrigerated |
Online Resources for Healthcare Professionals
| • | Access our online Test Menu |
| • | Simplify test ordering and results reporting with Care360™ |
| • | Stay informed with articles from the Quest Diagnostics Physician's Update Newsletter |
Online Test Information for Your Patients
Your patients can learn about health conditions and laboratory tests in our online Patient Health Library. The library is founded on evidence-based information, provides printer friendly formats, and includes topics such as:
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* The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed.
References
