Celiac Profile - Serum

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.¹ 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.²
• 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

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

²Kumar 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(s)

0078 - Celiac Profile
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

Analytes

Anti-Gliadin IgA II
Total Immunoglobulin A
Transglutaminase antibody (IgA)

Specimen Collection Instructions

• Allergix-KI.pdf

Sample Reports Example of how test results will be reported, including reference ranges and graphs indicating high and low percentiles of each analyte.

• Celiac-SR.pdf

Patient Briefs

• Celiac-PB.pdf

If you do not have the free Adobe Acrobat Reader, download it here.

Articles

• Celiac Disease - An estimated three million Americans have celiac disease, but most do not even know it. Celiac disease is the most common inherited autoimmune illness in America. It is thought to affect 1% of the entire U.S. population, though 98% of those who have it have not been diagnosed.

Books

• Laboratory Evaluations for Integrative and Functional Medicine - Your evidence-based resource for the biochemical basis of chronic illness. A must-have desk reference for laboratory testing associated with nutritional and metabolic medicine.

Case Studies

• 29-Year-Old Female with Ulcerative Colitis - EM was a 29-year-old female presenting with extremely active ulcerative colitis (UC). Colonoscopy had detected pancolitis. She was at her lowest body weight since adulthood. She had chronic diarrhea and severe fatigue.

Podcasts

• Gut-Brain Connection: An Inside Look at Depression - During a recent Metametrix sponsored breakfast at the IFM Symposium in Hollywood, Florida, Dr. Todd LePine gave a compelling presentation entitled the Gut-Brain Connection: An Inside Look at Depression.
• Naturopathic Approaches to Pain Patients - In this edition of Clinician’s Corner, Dr. Kara Fitzgerald, ND shares her clinical tools and treatments that have resulted in remarkable improvement for patients who had otherwise given up all hope of getting better.

Presentations

• IFM: The New Paradigm of Medicine - This PowerPoint presentation was developed by the Institute for Functional Medicine. It provides a concise explanation of the new paradigm of medicine that focuses on underlying causes of disease and treatment from that level rather treating symptoms alone, the approach often taken by modern medicine.

References

• Celiac Disease References