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.