Celiac Disease Evaluation

Last Modified: 7/5/2022 12:42:20 PM


Medical Necessity Documentation:  No Reticulan Antibodies will be resulted due to Reagent Backordered. 

The Celiac Disease Evaluation Panel (EPIC Test Code IMO123) includes measurement of Reticulin IgA and IgG antibody through Quest Diagnostics.  Quest Diagnostics experienced a disruption to their reagent supply for Reticulin IgA and IgG testing beginning in May 2022.  Samples were held at a Quest laboratory with the anticipation that reagent would be available in mid-June 2022.  The anticipated reagent supply was not received and currently has no estimated delivery date.  An alternate lab for Reticulin IgA and IgG testing has not been identified at this time.  Because future availability is unknown, current pending orders for Reticulin IgA and IgG are being cancelled.  Quest Diagnostics recommends substituting tissue Transglutaminase IgA and IgG which are already included in the Celiac Disease Evaluation Panel.  Future orders for the Celiac Disease Evaluation Panel will not include Reticulin IgA and IgG antibody until this reagent backorder has been resolved.

Client Notes:  
Patient Preparation:  
Specimen Requirements:

4.0 mL Serum in a SST Gold Top Tube

Collection Instructions:  
Minimum Volume: 2.0 mL Serum
Transport & Storage: Temperature/Stability: 48 hours Refrigerated
30 days Frozen


Specimen to be transported Refrigerated to PRMC within 48 hours of collection to be frozen by Immunology department to maintain specimen integrity until testing occurs. Do not transport Frozen.
Reference Range:

IgA

 0 days - 1 Month 1.3-2.7 mg/dL
1 Month - 2 Months 1.2-39.9 mg/dL
2 Months - 3 Months 2.5-35.4 mg/dL
3 Months - 4 Months 4.1-34.7 mg/dL
4 Months - 5 Months 4.0-54.9 mg/dL
5 Months - 6 months 7.2-63.2 mg/dL
6 Months - 7 Months 7.2-51.2 mg/dL
7 Months - 10 Months 9.8-67.7 mg/dL
10 Months - 1 Year 14.2-63.2 mg/dL
1 Year - 2 Year 12.5-79.5 mg/dL
2 Year - 3 Year 12.5-92.6 mg/dL
3 Year - 4 Year 19.6-119.6 mg/dL
4 Year - 6 Year 22.3-115.9 mg/dL
6 Year - 9 Year 29.4-152.0 mg/dL
9 Year - 10 Year 40.1-177.5 mg/dL
10 year - 200 Year 61.0-289.0 mg/dL

Tissue Transglutaminase IgG Autoantibodies:
Tissue Transglutaminase IgA Autoantibodies: < 4.0 U/mL 

Reticulin Ab (IgA) Screen: Negative   
Endomysial Ab (IgA) Screen: Negative   
Gliadin Ab (IgG): < 20 Units 
Gliadin Ab (IgA): < 20 Units 
Reticulin Ab (IgA) Titer: < 1:10 titer 
Endomysial Ab (IgA) Titer:  < 1:5 titer 
Critical Ranges:  
Test Comments:  
Methodology: Multiple
Clinical Significance:
Comprehensive evaluation of gluten sensitivity characteristic of Celiac disease. A high percentage of patients with Celiac disease also have IgA deficiency. Celiac disease or gluten sensitive entropathy is a chronic condition that damages the lining of the small intestine and results in a malabsorption syndrome. Detection of antibodies to gliadin, one of the major protein components of gluten, is useful in diagnosing celiac disease. However, gliadin antibodies may be found in individuals without celiac disease; thus gliadin antibody assays are less specific than assays measuring antibodies to endomysium and transglutaminase. Recent work has revealed that gliadin-reactive antibodies from celiac patients bind to a very limited number of specific epitopes on the gliadin molecule. Further, deamidation of gliadin results in enhanced binding of gliadin antibodies. Based on this information, assays using deamidated gliadin peptides bearing the celiac-specific epitopes have much higher diagnostic accuracy for celiac disease when compared to standard gliadin antibody assays
Documentation:  
Custom Panel: No

PRODUCTION SCHEDULE

Turn Around Time: 3 to 7 days
Days Performed: Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed: Parkview Regional Medical Center, Quest - Chantilly
PHL Test Code: CELP
EPIC Test Code: IMO123
Alternate Test Names: Celiac Disease Ab Panel; Gluten Enteropathy
Included Tests: Endomysial IgA Autoantibodies; Gliadin IgA Antibodies; Gliadin IgG Antibodies; IgA Total; Reticulin IgA Autoantibodies; Reticulin IgG Autoantibodies; Transglutaminase IgA Autoantibodies; Transglutaminase IgG Autoantibodies
CPT Coding: 82784 x 1, 83516 x 4 and 86255 x 3

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