Celiac Profile

The Celiac Profile uses widely accepted immunologic biomarkers to aid in the diagnosis of Celiac disease (CD). Epidemiologic studies estimate a worldwide prevalence of CD of approximately 1:100 individuals, with a considerable proportion of patients remaining undiagnosed and untreated.1

What is measured on the Celiac Profile?

The Celiac Profile is a blood test that measures important markers to aid in the diagnosis of CD including Total IgA, Anti-Tissue Transglutaminase IgA (tTG IgA) and IgG (tTG IgG), Anti-Deamidated Gliadin IgA (DGP IgA) and IgG (DGP IgG), and reflex Anti-Endomysial IgA (EMA IgA). Along with these results, Genova's unique report configuration provides a simple diagnostic algorithm to aid clinicians in assessing likelihood of disease.

What is Celiac Disease and when should testing be considered?

Celiac disease is defined as an autoimmune enteropathy of the small intestine, caused by exposure to dietary gluten in genetically pre-disposed individuals. In susceptible individuals, gluten ingestion generates an inflammatory reaction predominantly centered in the upper parts of the small intestine. This mucosal injury will eventually reduce the intestinal absorptive area and interfere with uptake of micronutrients.2

Conditions and symptoms associated with Celiac disease1,3,4

  • Chronic diarrhea with weight loss
  • Steatorrhea
  • Postprandial abdominal pain
  • Bloating
  • Malabsorption with nutrient deficiencies (iron, B12, calcium)
  • Irritable bowel syndrome
  • Elevated liver enzymes
  • Cerebellar ataxia
  • Peripheral neuropathy
  • Type I Diabetes
  • Autoimmune hepatitis
  • Autoimmune thyroiditis
  • Infertility
  • Dermatitis herpetiformis
  • Sjogren syndrome
  • Addison's disease
  • Parathyroid disorders
  • Growth hormone deficiency
  • Primary biliary cirrhosis
  • Primary sclerosing cholangitis

Testing should be performed while the patient is still on a gluten-containing diet.1 The exception is follow-up testing for monitoring treatment efficacy.

Ordering the test

The Celiac Profile can be ordered as a stand-alone test or bundled with other profiles. Often times, clinicians will bundle several smaller profiles in order to see a more complete picture of the patient's immune mediated response. Profiles that can be bundled include:

ProfileIncludes
IgG Foods 87 foods plus total IgE
IgG Vegetarian 21 foods plus total IgE
IgG Spices 24 spices plus total IgE
IgE Foods 19 foods plus total IgE
IgE Molds 15 molds plus total IgE
IgE Inhalants 16 inhalants specific to 18 North American geographic regions plus total IgE
Celiac Profile Total IgA, tTG IgA, tTG IgG, DGP IgA, DGP IgG and EMA IgA

The video below explains how these tests can be bundled.

What advantage does the Celiac Profile offer compared to other diagnostics?

Intestinal biopsy is considered the gold standard for the diagnosis of Celiac disease. International guidelines suggest that measuring immunologic analytes and genetic markers are favored to increase detection of CD. The European Society for Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) introduced a revised guideline for CD in children based on the optimization of antibody assays. According to this guideline, children can be diagnosed with CD without a duodenal biopsy when presenting with suspicious symptoms, a strongly elevated tTG-IgA (>10 confirmed cut-off value), confirmed by a positive EMA-IgA on a separate occasion, and positive genetic testing (HLA-DQ2 and /or HLA-DQ8).5 Genova does not offer the HLA-DQ2/DQ8 genetic markers.

Genova's Methodology

Genova's Celiac Profile is run on an automated platform called Phadia 250. This is an FDA-cleared fluorescence enzyme immunoassay and, therefore, FDA-cleared reference ranges are provided.

What can clinicians and patients expect from Celiac testing?

Clinical management of the patient with Celiac disease involves strict, lifelong elimination of gluten.

Please visit our test prep page prior to ordering the test to learn about medications that may impact test results, length of exposure to antigens, pediatric testing, and diseases that may affect antibody levels.

References

  1. Elli L, Branchi F, Tomba C, et al. Diagnosis of gluten related disorders: Celiac disease, wheat allergy and non-celiac gluten sensitivity. World J Gastroenterol. 2015;21(23):7110-7119.
  2. Castillo NE, Theethira TG, Leffler DA. The present and the future in the diagnosis and management of celiac disease. Gastroenterol Rep. 2015;3(1):3-11.
  3. Rubio-Tapia A, Hill ID, Kelly CP, Calderwood AH, Murray JA. ACG clinical guidelines: diagnosis and management of celiac disease. Am J Gastroenterol. 2013;108(5):656-676; quiz 677.
  4. Kelly CP, Bai JC, Liu E, Leffler DA. Advances in diagnosis and management of celiac disease. Gastroenterology. 2015;148(6):1175-1186.
  5. Husby S, Koletzko S, Korponay-Szabo IR, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease. J Ped Gastroenterol Nutr. 2012;54(1):136-160.
Analyte List
Anti-Deamidated Gliadin IgA (DGP IgA)
Anti-Deamidated Gliadin IgG (DGP IgG)
Anti-Tissue Transglutaminase IgA
Anti-Tissue Transglutaminase IgG (tTG IgG)
EMA IgA (reflex Only)
Total IgA
CPT Codes  
Anti-Deamidated Gliadin IgA (DGP IgA) 83516
Anti-Deamidated Gliadin IgG (DGP IgG) 83516
Anti-Tissue Transglutaminase IgA 83516
Anti-Tissue Transglutaminase IgG (tTG IgG) 83516
EMA IgA (reflex Only) 86255
Total IgA 82784
Specimen Requirements