Celiac Disease Comprehensive Panel

Message

SRHC Clients:

Note: For children age 4 years or less order Quest test code 15981X, Celiac Disease Panel Comprehensive, Infant. Order as a "Miscellaneous test" or an "Additional Test Order" in electronic order entry.

Outreach/Qutpatients:

1 red top tube (no gel) - due to reflex testing
Transport to SRHC refrigerated same day collected

Inpatients:

1 red top tube (no gel) - due to reflex testing
Transport to SRHC Laboratory within 8 hours

Test Code

LAB4443524

Quest Code

19955

Alias/See Also

Celiac Sprue Panel, Comprehensive
Sprue Panel

CPT Codes
86364, 82784

Includes

Tissue Transglutaminase (tTG) Antibody (IgA)
IgA (Immunoglobulin A)

If Tissue Transglutaminase (tTG) Antibody (IgA) is Detected (≥15.0 U/mL), then Endomysial Antibody Screen (IgA) will be performed at an additional charge (CPT code(s): 86231).
If Endomysial Antibody Screen (IgA) is Positive, then Endomysial Antibody Titer will be performed at an additional charge (CPT code(s): 86231).

If Immunoglobulin A is less than the lower limit of the reference range, based on age, 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 mL

Instructions

Please note: This panel is for patients who are >3 years old

Transport Container

Plastic screw-cap vial

Transport Temperature

Refrigerated (cold packs)

Specimen Stability

Room temperature: 72 hours
Refrigerated: 7 days
Frozen: 21 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Gross hemolysis • Grossly lipemic

Methodology
Immunoassay (IA) • Immunoturbidimetric

Setup Schedule

Set up: Tues-Sat; Report available: Next day

Reference Range

Tissue Transglutaminase (tTG) Antibody (IgA)

<15.0 U/mL		Antibody not detected
≥15.0 U/mL		Antibody detected

IgA (Immunoglobulin A)

Cord Blood	Not Established
≤3 months	5-40 mg/dL
4-6 months	7-47 mg/dL
7-11 months	12-53 mg/dL
1 year	20-73 mg/dL
2 years	20-99 mg/dL
3-5 years	22-140 mg/dL
6-8 years	31-180 mg/dL
9-11 years	33-200 mg/dL
12-16 years	36-220 mg/dL
17-60 years	47-310 mg/dL
≥61 years	70-320 mg/dL

Clinical Significance

Celiac disease is caused by an immune response to gluten in genetically sensitive individuals. The diagnosis is largely based on a biopsy of the small intestine, but serologic tests also help support a diagnosis and may assist identification of patients who may require biopsy.
Tissue transglutaminase antibodies (tTG, IgA) is a marker with 95% sensitivity and specificity. Total IgA is measured because 2-3% of celiac disease patients are IgA deficient. Because tTG, IgA, and anti-Gliadin IgA tend to decrease in patients on a gluten-free diet, these markers are also used to assess dietary compliance.
The endomysial antibody (EMA, IgA) assay has high specificity for celiac disease and is used to confirm positive anti-tTG results.

Performing Laboratory
Quest Diagnostics Nichols Institute
14225 Newbrook Drive
Chantilly, VA 20153

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.