The Celiac Panel at Upstate

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People with Celiac Disease (CD) cannot completely digest gluten. The peptide portion of gliadin resists digestion and is responsible for initiating the inflammatory response.

The majority of patients with CD make IgA antibodies. Studies have shown a very small number (2–3%) of CD patients are IgA deficient and they would then make IgG antibodies. For this reason, IgA is included in the Celiac Panel. If the IgA is less than 7 mg/dl, the Tissue Transglutaminase IgG Antibody (TTGG) is reflexively ordered.

The Celiac Panel (celp) consists of the following:

  • IgA—if<7mg/dl, it will reflex to TTGG
  • TTGA—Tissue Transglutaminase IgA Antibody
  • DGP—Deamindated Gliadin Peptide IgG/IgA Antibody

Gliadin testing is no longer recommended since the DGP is more specific and sensitive for CD. The Immunology lab can still send out an Endomysial IgA level if the TTGA is positive as that is the prerequisite before the reference lab will perform Endomysial testing. It is important to note that the Endomysial IgA antibody test uses monkey esophagus (extremely rare tissue), is labor intensive, subjectively read and very expensive. The Endomysial antibody test measures the same antigen as the TTGA so it should correspond with the TTGA. Patient serum is saved for one month in the Immunology lab at Upstate. Please call 464-4463 if you wish to add on the Endomysial antibody test.

The TTGA is slightly more sensitive (93%) than DGP (88%) and significantly more sensitive than gliadin (80%). However, in children under the age of 2, DGP may become positive before the TTGA. It has also been noted that diabetic patients with high glucose levels may have a transient elevated TTGA when first diagnosed.

For more information please call the Immunology Laboratory at 315 464-4463.