Celiac Profile - Serum

Celiac Disease – An Often Misdiagnosed Condition

The Metametrix Celiac Profile

The Celiac Test measures IgA-tTG, Serum IgA, and IgA-AGA. When IgA-tTG and IgA-AGA are positive, there is a high degree of certainty the patient has celiac disease. When IgA-tTG is positive with normal IgA-AGA, the patient may have celiac disease, but may have been following a gluten-free diet, reducing their IgA-AGA. Individuals with moderate to strong positives should follow up with a biopsy.

What is Celiac Disease?

It is estimated that more than 2 million people in the United States alone have celiac disease.² Celiac disease is an autoimmune response to gluten. Inherited factors make some individuals sensitive to a protein called gliadin, which is a part of the total protein or gluten found in grains such as wheat, rye, and barley. When people with celiac disease ingest gluten, their immune system responds by damaging their intestinal villi – the tiny, fingerlike protrusions lining the small intestine. Villi normally allow nutrients from food to be absorbed through the walls of the small intestine into the bloodstream. Damaged villi can lead to long-term complications from impaired absorption such as malnutrition, anemia, osteoporosis, and miscarriage, among other problems.

Components of the Celiac Test:

• IgA human tissue transglutaminase (IgA-tTG): Occurs as an immune response to tissue transglutaminase and is rarely found in individuals without celiac disease.
• Serum IgA: Identifying serum IgA deficiencies are important for two reasons. First, IgA deficiencies can lead to false negatives for IgA-tTG. Second, individuals with an IgA deficiency have a 10 - 15 times greater risk of developing celiac disease.³
• IgA antigliadin antibody (IgA-AGA): This antibody develops against gliadin showing consumption of gluten-containing foods that can propagate the enteropathy of celiac disease.

People with celiac disease experience varied symptoms or no symptoms, but can still develop complications of the disease. The following symptoms may indicate a need for a celiac test:

• Unexplained iron-deficiency anemia

• Fatigue
• Bone or joint pain
• Arthritis
• Bone loss or osteoporosis
• Depression or anxiety
• Autoimmune diseases
• Tingling numbness in the hands and feet
• Seizures
• Missed menstrual periods
• Infertility or recurrent miscarriage
• Canker sores inside the mouth
• An itchy skin rash called dermatitis Herpetiformis

Gliadin Sensitivity Profile

To assess gluten sensitivity, this profile offers a simple, salivary collection measuring anti-gliadin antibody (AGA) and secretory immunoglobulin A (sIgA). AGA measures the body's response to gluten while SIgA defends against antigenic and infectious attacks at the mucosal surfaces. To order a collection kit, click here.

¹ Anderson, R., Celiac Disease. Australian Family Physician, 2005. 34(4):p.239-242.

² Westberg, D.P., et al., New Strategies for diagnosis and management of celiac disease. J Am Osteopath Assoc, 2006. 18(1):p.145-51.

³Kumar V, Celiac disease and immunoglobulin a deficiency: how effective are the serological methods of diagnosis? http://www.cfsan.fda.gov/~dms/gluthami/gluham4.htm, 2002.

Test name:	0078- Celiac Profile - Serum 0278- IgG4 Food Antibodies and Celiac Profile
Description:	Celiac disease is an immune mediated response to gluten that affects the gastrointestinal tract. The celiac profile is composed of three tests: IgA human tissue translutaminase (IgA-tTG), Serum IgA, and IgA antigliadin antibody (IgA-AGA). The profile combines the three tests to accurately identify those likely to have celiac disease.
Method:	ELISA and Immunoturbidometric assay
Turnaround time:	6 - 8 days, 7 days average
Antigens:	Anti-Gliadin IgA II Total Immunoglobulin A Transglutaminase antibody (IgA)

Profile 0078 – Celiac Profile 83516 x2 - Gliadin IgA / Anti-Gliadin IgA II 82784 - IgA -------------------------------------------------------------- Profile 0072 – Gliadin Sensitivity Profile 83516 - Salivary Secretory IgA 83516 - Salivary Antigliadin IgA

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	References Celiac Disease
	New strategies for diagnosis and management of celiac disease. Westerberg DP, Gill JM, Dave B, DiPrinzio MJ, Quisel A, Foy A. J Am Osteopath Assoc. 2006 Mar;106(3):145-51. Update on the evaluation and diagnosis of Celiac disease. Leffler, D.A. and C.P. Kelly. Curr Opin Allergy Clin Immunol, 2006. 6(3): p. 191-6. New strategies for diagnosis and management of Celiac disease. Westerberg, D.P., et al., J Am Osteopath Assoc, 2006. 106(3): p. 145-51. Celiac sprue (the great modern-day imposter). Lee, S.K. and P.H. Green. Curr Opin Rheumatol, 2006. 18(1): p. 101-7. Celiac disease as a cause of iron deficiency anemia. Sabel'nikova, E.A., et al., Ter Arkh, 2006. 78(2): p. 45-8. Dermatitis herpetiformis and partial IgA deficiency. Samolitis, N.J., et al., J Am Acad Dermatol, 2006. 54(5 Suppl): p. S206-9. Duration of exposure to gluten and risk for autoimmune disorders in patients with Celiac disease. Ventura, A., G. Magazzu, and L. Greco. SIGEP Study Group for Autoimmune Disorders in Celiac Disease. Gastroenterology, 1999. 117(2): p. 297-303. Current approaches to diagnosis and treatment of Celiac disease: an evolving spectrum. Fasano, A. and C. Catassi. Gastroenterology, 2001. 120(3): p. 636-51. Performance of antibodies against tissue transglutaminase for the diagnosis of Celiac disease: meta-analysis. Zintzaras, E. and A.E. Germenis. Clin Vaccine Immunol, 2006. 13(2): p. 187-92. Comparative studies of different gliadin preparations in detecting antigliadin antibodies Kumar, V., et al. J Pediatr Gastroenterol Nutr, 1986. 5(5): p. 730-4. Does cryptic gluten sensitivity play a part in neurological illness? Hadjivassiliou, M., et al., Lancet, 1996. 347(8998): p. 369-71. Celiac disease: a diverse clinical syndrome caused by intolerance of wheat, barley and rye. McGough, N. and J.H. Cummings. Proc Nutr Soc, 2005. 64(4): p. 434-50.