Specialized Testing
Celiac Disease
Recent literature has reported that Celiac disease (CD) is a more common disorder in the United States than previously recognized. A recent Pediatric Grand Rounds, addressing celiac disease, recommended that a serologic evaluation is an important part in the diagnosis.
Pediatric Celiac Disease
Recent literature has reported that Celiac disease (CD) is a more common disorder in the United States than previously recognized. A recent Pediatric Grand Rounds, addressing celiac disease, recommended that a serologic evaluation is an important part in the diagnosis. Dr. Kevin Donovan, pediatric gastroenterologist, recommends that serology testing be divided by age. In the evaluation of serology for toddlers (<3 yrs), Dr Donovan recommends that the Pediatric Celiac Serology Panel (see below) be utilized whereas for the older children (>3 yrs) the Celiac Analyzer (see below) be the testing of choice. An important part of serology, regardless of age, is testing for total IgA since IgA deficiency is 10-15 times greater in patients with CD. In the older children any patient found to be IgA anti-tissue transglutaminase (IgA anti-tTG) negative and IgA deficient will be automatically evaluated for IgG anti-tissue transglutaminase antibodies (IgG anti-tTG). In toddlers, IgG anti-tTG is not reliable, and referral for a small bowel biopsy is recommended for those with serum IgA deficiency.
| Celiac Serology for Toddlers, <3 years |
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Pediatric Celiac Disease Panel |
Order Name: PED CELIAC Test Number: 5537675 |
Panel DetailsIgA anti-tissue transglutaminase antibodyDeamidated Gliadin IgA Total serum IgA level |
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Specimen Requirements2mL(1mL) Serum, Clot Activator SST, Refrigerated |
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| Celiac Serology for Children >3 years and Adults |
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Celiac Disease Analyzer |
Order Name: CELIAC AN Test Number: 5537700 |
Analyzer DetailsIgA anti-tissue transglutaminase antibodyDeamidated Gliadin IgA Deamidated Gliadin IgG Total serum IgA level (The Analyzer will automatically reflex to test for IgG anti-tissue transglutaminase antibody if the celiac suspected patient is identified as being deficient for total serum IgA.) |
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Specimen Requirements4mL(2mL) Serum, Clot Activator SST, Refrigerated View in Test Directory | View the Analyzer Specifics The Celiac Analyzer minimizes the testing needed to confirm the diagnosis of Celiac Disease. Initial serology tests are performed for the detection of quantitative IgA, the utilization of the synthetic gliadin-related deamidated peptides (Deamidated IgG anti-gliadin, Deamidated IgA anti-gliadin) and IgA anti-human tissue transglutaminase (tTG) which has emerged as a very sensitive and specific means to support the diagnosis and management of patients with Sprue. Patients found to be IgA deficient will automatically be evaluated for IgG anti-tissue Transglutaminase antibodies. |
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REFERENCES:
Fasanc, A., I Berti, T Gerarduzzi, et.al. 2003. Prevalence of celiac disease in at-risk and not-at-risks groups in the United States. Arch. Intern. Med. 163:286-292.
Wong, R.C., R.J. Wilson, R.H. Steele, G. Radford-Smith and S. Adelstein. 2002. A comparison of 13 guinea pig and human anti-tissue transglutaminase antibody ELISA kits. J. Clin. Pathol. 55:488-494.
Kuman, V., M. Jarzabek-Chorzelska, J. Sulej, K Karnewska, T Farrell and S. Jablonska. 2002. Celiac Disease and immunoglobulin A deficiency: How effective are serological methods of diagnosis? Clin. Diagn. Lab. Immunol. 4:1295-1300.
Gomez, J.C., G. Selvaggio, B. Pizarro, et.al. 2002. Value of a Screening algorithm for celiac disease using tissue transglutaminase antibodies as first level in a population-based study. Amer. J. Gastroenterology 97: 2785-2790.
Kagnoff, M.F. 2002. Celiac disease pathogenesis: The plot thickens. Gastroenterology 123: 939-943.
Korponay-Szabo, R., et.al. 2003. Elevation of IgG antibodies against tissue transglutaminase as a diagnostic tool for celiac disease in selective IgA deficiency. Gut 52:1567-71.