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Celiac Disease Comprehensive Panel with Gliadin Antibodies(Age 5 and Under)
Test Code36331
CPT Codes
86258 (x2), 86364, 82784
Includes
Tissue Transglutaminase (tTG) Antibody (IgA)
Gliadin (Deamidated) Antibody (IgG, IgA)
IgA (Immunoglobulin A)
If Tissue Transglutaminase (tTG) Antibody (IgA) is Detected (≥15.0 U/mL), then Endomysial Antibody (IgA) Screen with Reflex to Titer will be performed at an additional charge (CPT code(s):86231).
If Endomysial Antibody (IgA) Screen is Positive, then Endomysial Antibody Titer will be performed at an additional charge (CPT code(s): 86231).
If Immunoglobulin A is flagged as low based on age appropriate reference range, or if no age is provided and Immunoglobulin A result is <31 mg/dL, then Tissue Transglutaminase (tTG) Antibody (IgG) will be performed at an additional charge (CPT code(s): 86364).
Gliadin (Deamidated) Antibody (IgG, IgA)
IgA (Immunoglobulin A)
If Tissue Transglutaminase (tTG) Antibody (IgA) is Detected (≥15.0 U/mL), then Endomysial Antibody (IgA) Screen with Reflex to Titer will be performed at an additional charge (CPT code(s):86231).
If Endomysial Antibody (IgA) Screen is Positive, then Endomysial Antibody Titer will be performed at an additional charge (CPT code(s): 86231).
If Immunoglobulin A is flagged as low based on age appropriate reference range, or if no age is provided and Immunoglobulin A result is <31 mg/dL, then Tissue Transglutaminase (tTG) Antibody (IgG) will be performed at an additional charge (CPT code(s): 86364).
Preferred Specimen
5 mL serum
Minimum Volume
1.1 mL
Transport Temperature
Room temperature
Specimen Stability
Room temperature: 72 hours
Refrigerated: 7 days
Frozen: 21 days
Refrigerated: 7 days
Frozen: 21 days
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Gross hemolysis • Grossly lipemic
Methodology
Immunoassay (IA) • Immunoturbidimetric Assay
Setup Schedule
See individual assays
Clinical Significance
This panel is used to assist in the diagnosis of celiac disease (CD) in children ≤5 years old.
Background: CD is caused by an immune response to gluten in genetically sensitive individuals. Diagnosis begins with serologic testing and is confirmed by biopsy. This panel tests all specimens for tissue transglutaminase (tTG) IgA and gliadin (deamidated) IgA and IgG. Although tTG IgA is generally preferred as a single serological test for CD, it may have reduced sensitivity in young children; including DGP IgA and IgG alongside tTG IgA may increase sensitivity for CD. Specimens positive for tTG IgA are tested for endomysial antibody (IgA), which may increase specificity for CD. This panel also evaluates all specimens for total IgA. A total IgA level below the reference range is suggestive of IgA deficiency and reflexes to tTG IgG, which is generally less sensitive than tTG IgA for CD but is useful in the context of IgA deficiency.
Background: CD is caused by an immune response to gluten in genetically sensitive individuals. Diagnosis begins with serologic testing and is confirmed by biopsy. This panel tests all specimens for tissue transglutaminase (tTG) IgA and gliadin (deamidated) IgA and IgG. Although tTG IgA is generally preferred as a single serological test for CD, it may have reduced sensitivity in young children; including DGP IgA and IgG alongside tTG IgA may increase sensitivity for CD. Specimens positive for tTG IgA are tested for endomysial antibody (IgA), which may increase specificity for CD. This panel also evaluates all specimens for total IgA. A total IgA level below the reference range is suggestive of IgA deficiency and reflexes to tTG IgG, which is generally less sensitive than tTG IgA for CD but is useful in the context of IgA deficiency.
