The Celiac Panel at Upstate
Celiac disease is an immune reaction to eating glutin, a protein found in wheat, barley, and rye. People with Celiac Disease (CD) cannot completely digest glutin. The peptide portion of gliaden 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 (approximately 3%) of CD patients are IgA deficient and they would then make IgG antibodies. For this reason, Serum IgA is included in the Celiac Panel. If the Serum IgA is less than the age-matched reference value, the Tissue Transglutaminase IgG Antibody (TTGG1) is reflexively ordered.
The Celiac Panel (CELP1) consists of the following:
- Serum IgA if less than the age-matched reference value, the TTGG1 will be ordered
- TTGA1 Tissue Transglutaminase IgA Antibody
- DGPA Deaminated Gliaden Peptide IgA Antibody
- DGPG Deaminated Gliaden Peptide IgG Antibody
Gliaden testing is no longer recommended since the DGP Antibodies are more specific and sensitive for CD. The Immunology Lab can still send out an Endomysial IgA level if the TTGA1 is positive, as that is a prerequisite before the reference lab will perform Endomysial testing. The Endomysial antibody test measures the same antigen as the TTGA1 so it should correspond with the TTGA1.
In children under the age of 2, Deaminated Gliadin Antibodies (IgA and IgG) may become positive before the TTGA1. Type I Diabetes is highly linked to Celiac Disease on a genetic level, and 5 to 10 percent of people with Type I Diabetes also have CD.
For more information please call the Immunology Laboratory at 315-464-4463.