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Celiac Disease Screen

Gluten, Sprue, Tropical Sprue, Celiac Disease Antibody Evaluation

Test Codes

Antrim #31432, EPIC: LAB5751, SOFT: CELDS

Department

Special Chemistry

Instructions

This panel includes: 

• Immunoglobulin A (IgA)
• Tissue Transglutasminase (IgA)

Specimen Collection Criteria

Collect: Two Gold-top SST tubes.

Physician Office/Draw Specimen Preparation

Let each specimen clot 30-60 minutes then immediately centrifuge to separate serum from cells. Refrigerate (2-8°C or 36-46°F) the centrifuged collection tube within two hours of collection. (Minimum Serum: 0.5 mL per tube)

Preparation for Courier Transport

Transport: Centrifuged collection tubes, refrigerated (2-8 °C or 36-46 °F). (Minimum Serum: 0.5 mL per tube)

Rejection Criteria

• Heat inactivated serum.
• Plasma specimens.
• Severely lipemic or hemolyzed specimens.
• Specimens that have gross bacterial contamination.  

In-Lab Processing

Let each specimen clot 30-60 minutes then immediately centrifuge to separate serum from cells. Room temperature is acceptable for a maximum of eight hours. (Minimum Serum: 0.5 mL per tube)

Storage

Specimen Stability for Testing:

Centrifuged SST Tubes and Microtainers^® with Separator Gels
Room Temperature (20-26°C or 68-78.8°F): 8 hours
Refrigerated (2-8°C or 36-46°F): 2 days
Frozen (-20°C/-4°F or below): Unacceptable

Red-top Tubes and Microtainers^® without Separator Gels
Room Temperature (20-26°C or 68-78.8°F): 8 hours
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): Unacceptable

Serum Specimens (Pour-Overs)
Room Temperature (20-26°C or 68-78.8°F): 8 hours
Refrigerated (2-8°C or 36-46°F): 2 days
Frozen (-20°C/-4°F or below): 3 months

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 7 days

Laboratory

Royal Oak Special Testing Laboratory

Performed

Results available within 2 business days.

Reference Range

IgA: 85-385 mg/dL.

Tissue transglutaminase antibodies (IgA):
Negative: Less than 20 Units.
Weak Positive: 20-30 Units.
Moderate-Strong Positive: Greater than 30 Units.

Test Methodology

Nephelometry and EIA.

Interpretation

Please see individual tests for interpretation. This panel includes: Immunoglobulin A (IgA) and Tissue Transglutaminase (IgA).

Clinical Utility

Useful to screen high-risk populations (e.g., first degree relatives of celiac patients, insulin dependent diabetics, etc.) for celiac disease. However, histologic confirmation is required for diagnosis. Patients should not begin a gluten-free diet until after intestinal biopsy has been performed and the diagnosis is established. Serial celiac antibody titers may at times be useful to monitor dietary compliance.

Selective IgA deficiency occurs more commonly in celiac disease (2-3 %) than in the general population (0-2%) and is likely to lead to a false negative result when IgA antibody screens are used in the diagnosis of celiac disease. Patients with an IgA of less than 7 mg/dL, who are suspected of having celiac disease, should be retested by the IgG-tissue transglutaminase antibody test or referred to a gastroenterologist.

CPT Codes

83516, 82784.

Contacts

Last Updated

1/4/2023