Specimens from children less than 4 years of age (i.e., less than 48 months) are not appropriate for this test. The test for children 4 years of age and younger is the Celiac Disease Comprehensive Panel, Infant (test code 15981).
Tissue Transglutaminase, IgA with Reflexes; Total IgA with Reflex
IMPORTANT - Note this is Reflex Test which if additional tests are run you will be charged for the specific tests that the lab peforms. Additional test will be run if the following criteria are met.
If the Tissue Transglutaminase IgA is positive,
1. Endomysial Antibody Screen (IgA) will be performed at an additional charge (CPT code(s): 86255).
If the Endomysial Antibody Screen (IgA) is positive,
2. Endomysial Antibody Titer will be performed at an additional charge (CPT code(s): 86256).
If the Total IgA is less than the lower limit of the reference range, based on age,
3. Tissue Transglutaminase IgG will be performed at an additional charge (CPT code(s): 83516).
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.