Celiac Disease Serology Cascade, Serum
Use
Evaluating patients suspected of having celiac disease, including those with compatible symptoms, atypical symptoms, and individuals at increased risk due to family history, previous diagnosis with associated diseases, or positive results for HLA-DQ2 and/or DQ8. This cascade provides a comprehensive approach for the serologic evaluation of celiac disease, particularly useful for identifying patients for whom a small intestinal biopsy might be unnecessary by identifying significant IgA-tTG levels.
Special Instructions
This cascade should not be used for patients who are on a gluten-free diet or those who are negative for HLA-DQ2 or DQ8 as their likelihood of having celiac disease is low. To order individual tests, see the Celiac Disease Diagnostic Testing Algorithm provided in the special instructions.
Limitations
This cascade alone should not be relied upon for a definitive diagnosis of celiac disease. False positives can occur, especially in cases of low or undetectable IgA levels, making selective IgA testing critical. A definitive diagnosis usually requires correlation with clinical findings and a duodenal biopsy. Elevated antibody levels may take time to normalize after starting a gluten-free diet, necessitating monitoring of adherence and potential disease refractoriness if levels remain high.
New York Approved
Methodology
Immunoassay (ELISA)
Biomarkers
LOINC Codes
- 94494-2
- 2458-8
- 69048-7
Result Turnaround Time
7-9 days
Related Documents
For more information, please review the documents below
Specimen
Serum
Volume
5 mL
Minimum Volume
2 mL
Container
Plastic vial
Collection Instructions
Centrifuge and aliquot serum into a plastic vial. Use a serum gel container for collection, and red top is acceptable. Sarstedt Aliquot Tube, 5 mL (T914) is supplied.
Causes for Rejection
Gross hemolysis, gross lipemia, gross icterus
Stability Requirements
| Temperature | Period |
|---|---|
| Refrigerated | 14 days |
| Frozen | 21 days |