Celiac cascade
Celiac cascade-12442
Celiac
TTG
DGP
- Total IgA
- If Normal or Elevated: TTg IgA is performed at an additional charge
- If TTG IgA result is Equivocal: Deamidated Gliadin IgA and Endomysial IgA will be performed at an additional charge
- If Total IgA is low but ≥7.0: TTg IgA, TTg IgG, and Deamidated Gliadin IgA and IgG are performed at additional charge
- If Total IgA is deficient < 7.0: TTg IgG and Deamidated Gliadin IgG are performed at additional charge
Celiac disease is characterized by gluten intolerance leading to a chronic malabsorptive disorder due to inflammation of the intestinal mucosa and flattening of the epithelium. Autoantibodies associated with celiac disease include; IgA anti-endomysial antibodies, IgG and IgA anti-gliadin antibodies and anti-reticulin antibodies. Several studies have demonstrated that IgA anti-endomysial tests have greater than 99% specificity for celiac disease with a greater sensitivity than anti-gliadin and anti-reticulin assays.
Immediately following collection, thoroughly mix sample by gently inverting 5 times
- Allow sample to clot for a minimum of 30 minutes
- Spin within two (2) hours of sample collection
Gold serum separator (SST) tube
- Allow sample to clot
- Spin
- Transfer serum to a False bottom plasma/serum transport vial/tube (AHL), labelled as serum, within two (2) hours of sample collection
Refrigerated (preferred) - 7 days
Frozen - 14 days
Ambient - NO
- Improper labels (unlabeled or mislabeled)
- Hemolysis (some procedures)
- Improper anticoagulant or ratio
- Heparinized plasma is not acceptable
- Delay in transport
- Improper storage temperature affecting results
- Improper container
- Leaking container resulting in compromised specimen
- Quantity not sufficient (QNS)
Enzyme-linked immunosorbent assay (ELISA)
IgA total
Adult: 50 – 450 mg/dL
TTg IgA
Negative: <4.0 U/mL
Weak positive: 4.0 - 10.0 U/mL
Strong positive: >10 U/mL
TTg IgG
Negative: <6 U/mL
Weak positive: 6.0 - 9.0 U/mL
Strong positive: >9 U/mL
Gliadin IgA
Negative: < 20 U/mL
Weak positive: 20 – 30 U/mL
Strong positive: >30 U/mL
Additional CPT codes (if appropriate):
86258 - Gliadin Ab IgA
86258 - Gliadin Ab IgG
86364 - Tissue Transglutaminase IgA
86364 - Tissue Transglutaminase IgG
17027680 - Gliadin Ab IgA
17029456 - Gliadin Ab IgG
17027678 - Tissue transglutaminase IgA
17027679 - Tissue transglutaminase IgG
308625801 - Gliadin Ab IgA
308625800 - Gliadin Ab IgG
308636400 - Tissue transglutaminase IgA
308636401 - Tissue transglutaminase IgG