Celiac Test

Celiac Test

Celiac disease (CD) is a relatively common autoimmune disease with a genetic component and an environmental trigger. In people with CD, eating gluten, a protein found in wheat, rye and barley can set off an auto-immune response that damages or destroys the villi – the tiny protrusions lining the small intestine, that allow for nutrients from food to be absorbed through the walls of the intestine into the bloodstream. This can lead to patients being malnourished or having other complications. Gluten is found mainly in foods but may also be found in everyday products such as medicines, vitamins and lip balms.

Diagnosis of celiac disease can be difficult as the symptoms can be varied and are similar to those of other diseases. As a result, celiac disease has often been under or misdiagnosed.

Highlights: Testing for celiac disease

Functional Assessment of: Celiac blood panel:

  1. tTG/Transglutaminase IgA Antibodies / anti-tissue transglutaminase IgA
  2. EMA/Endomysial IgA Antibodies/anti-endomysial antibodies IgA
  3. AGA-IgA/Gliadin IgA Antibodies/antigliadin antibodies- IgA
  4. AGA-IgG/Gliadin IgG Antibodies/Antigliadin antibodies)-IgG
  5. Total serum IgA (total serum, immunoglobulin A)

Indicated for those who: are anemic, experiencing digestive upset and or fatigue

To confiirm Celiac Disease (CD), three steps are taken:

1. Physical Exam & Celiac Blood Panel

2. Duodenal Biopsy- multiple locations in the small intestine.

3. Gluten Free Diet - When the patient shows a positive response to the diet – symptoms subside and the small intestine returns to its normal, healthy state – the diagnosis of CD is confirmed.

(NOTE: To ensure the most accurate and timely diagnosis, the gluten-free diet should be implemented only after the first two steps have been completed.)

What is being tested in the Celiac Test?

Blood tests can add valuable diagnostic information.  The most comprehensive panel of blood tests for gluten sensitivity and celiac disease includes five tests for antibodies. The Celiac Panel consists of :

  1. tTG/Transglutaminase IgA Antibodies / anti-tissue transglutaminase IgA :  This test is very specific to celiac  disease.  A highly specific marker for celiac disease, if positive.
  2. EMA/Endomysial IgA Antibodies/anti-endomysial antibodies IgA: This test is also specific to celiac disease. A highly specific marker for celiac disease, if positive , especially if tTG is positive also.
  3. AGA-IgA/Gliadin IgA Antibodies/antigliadin antibodies- IgA: The antigliadin tests are less specific for celiac disease, and these antibodies sometimes show up in other diseases (including gluten sensitivity). AGA-IgA is useful when testing young children, who don’t always produce enough tTG or EMA for diagnostic purposes.AGA-IgA is also useful for monitoring compliance on the gluten-free diet (if it’s still elevated after you’ve been gluten-free for several months, gluten may be sneaking into your diet). Some people feel that a positive AGA-IgA indicates gluten sensitivity.
  4. AGA-IgG/Gliadin IgG Antibodies/Antigliadin antibodies)-IgG: This is another antigliadin test (like the preceding one) and is less specific to celiac disease, but it may be useful in detecting gluten allergy or leaky gut syndrome.Also, if the IgG levels are highly positive and all the other tests are negative, that may signal that the patient is IgA-deficient, in which case the results of the other tests are erroneous.
  5. Total serum IgA (total serum, immunoglobulin A): A significant portion of the population is IgA-deficient, meaning their IgA production is always lower than normal. Three of the four tests above are IgA-based (the only one that isn’t IgA-based is antigliadin IgG), so in someone who’s IgA-deficient, results of those three tests would be falsely low. By measuring total serum IgA, doctors can determine whether a patient is IgA-deficient and can compensate when reading the results of the three IgA-based tests.

It is important that patients continue to eat a normal, gluten-containing diet before being tested. If symptoms and blood tests are suggestive of celiac disease, a small biopsy of the small intestine is performed to confirm diagnosis.

What are the common signs present on physical exam?

  • Pallor (due to anemia)
  • Hypotension (low blood pressure)
  • Edema (due to low levels of protein, [albumin] in the blood)
  • Dermatitis herpetiformis (skin lesions)
  • Easy bruising (lack of vitamin K)
  • Bone or skin and mucosa membrane changes due to vitamin deficiencies
  • Bloating  or distended abdomen (intestine dysmotility)
  • Loss of various sensations in extremities including vibration, position and light touch (vitamin deficiency)
  • Signs of severe vitamin/mineral deficiencies which may include: diminished deep tendon reflexes, muscle spasms (magnesium and/or calcium deficiency), bone tenderness and bone pain (due to osteomalacia)

Fee Schedule:

146

Consult: 98

( It is recommended to have a consult to integrate your results for your optimal health plan)