Sorted By Test Name - Mayo Medical Laboratories

DAGL
89029
suggest poor adherence to the gluten-free diet or the possibility of refractory celiac disease.(1) See Celiac
Disease Diagnostic Testing Algorithm in Special Instructions for the recommended approach to a patient
suspected of celiac disease. An algorithm is available for monitoring the patient's response to treatment,
see Celiac Disease Routine Treatment Monitoring Algorithm in Special Instructions. For your
convenience, we recommend utilizing cascade testing for celiac disease. Cascade testing ensures that
testing proceeds in an algorithmic fashion. The following cascades are available; select the appropriate
one for your specific patient situation. Algorithms for the cascade tests are available in Special
Instructions. -CDCOM/89201 Celiac Disease Comprehensive Cascade: complete testing including HLA
DQ -CDSP/89199 Celiac Disease Serology Cascade: complete testing excluding HLA DQ -CDGF/89200
Celiac Disease Comprehensive Cascade for Patients on a Gluten-Free Diet: for patients already adhering
to a gluten-free diet To order individual tests, see Celiac Disease Diagnostic Testing Algorithm in Special
Instructions.
Useful For: Evaluating patients suspected of having celiac disease; this includes patients with
symptoms compatible with celiac disease, patients with atypical symptoms, and individuals at increased
risk of celiac disease Evaluating the response to treatment with a gluten-free diet
Interpretation: Positive test results for deamidated gliadin antibodies, IgA or IgG, are consistent with
the diagnosis of celiac disease. Negative results indicate a decreased likelihood of celiac disease.
Decreased levels of deamidated gliadin antibodies, IgA or IgG, following treatment with a gluten-free diet
are consistent with adherence to the diet. Persistence of high levels of antibodies following dietary
treatment suggest poor adherence to the diet or the presence of refractory disease. See Celiac Disease
Diagnostic Testing Algorithm in Special Instructions for the recommended approach to a patient
suspected of celiac disease. An algorithm is available for monitoring the patient's response to treatment,
see Celiac Disease Routine Treatment Monitoring Algorithm in Special Instructions.
Reference Values:
Negative: 30.0 U
Clinical References: 1. Green PH, Cellier C: Celiac disease. New Engl J Med 2007;357:1731-1743
2. Green PH, Jabri B: Celiac disease. Annu Rev Med 2006;57:207-221 3. Harrison MS, Wehbi M,
Obideen K: Celiac disease: More common than you think. Cleve Clin J Med 2007;74:209-215 4. Dale JC,
Homburger HA, Masoner DE, et al: Update on celiac disease: New standards and new tests. Mayo
Communique 2008;33(6):1-9 5. Rashtak S, Ettore MW, Homburger HA, et al: Comparative usefulness of
deamidated gliadin antibody measurements in the diagnosis of celiac disease. Clin Gastroenterol Hepatol
2008 Apr;6(4):426-432 6. Sugai E, Vazquez H, Nachman F, et al: Accuracy of testing for antibodies to
synthetic gliadin-related peptides in celiac disease. Clin Gastroenterol Hepatol 2006;4:1112-1117
Gliadin (Deamidated) Antibody, IgA, Serum
Clinical Information: Celiac disease (gluten-sensitive enteropathy, celiac sprue) results from an
immune-mediated inflammatory process that occurs in genetically susceptible individuals following
ingestion of wheat, rye, or barley proteins.(1) The inflammation in celiac disease occurs primarily in the
mucosa of the small intestine, which leads to villous atrophy.(1) Common clinical manifestations related
to gastrointestinal inflammation include abdominal pain, malabsorption, diarrhea, and/or constipation.(3)
Clinical symptoms of celiac disease are not restricted to the gastrointestinal tract. Other common
manifestations of celiac disease include failure to grow (delayed puberty and short stature), iron
deficiency, recurrent fetal loss, osteoporosis, chronic fatigue, recurrent aphthous stomatitis (canker sores),
dental enamel hypoplasia, and dermatitis herpetiformis.(4) Patients with celiac disease may also present
with neuropsychiatric manifestations including ataxia and peripheral neuropathy, and are at increased risk
for development of non-Hodgkin lymphoma.(1,2) The disease is also associated with other clinical
disorders including thyroiditis, type I diabetes mellitus, Down syndrome, and IgA deficiency.(1,3) Celiac
disease tends to occur in families; individuals with family members who have celiac disease are at
increased risk of developing the disease. Genetic susceptibility is related to specific HLA markers. More
than 97% of individuals with celiac disease in the United States have DQ2 and/or DQ8 HLA markers
compared to approximately 40% of the general population.(3) A definitive diagnosis of celiac disease
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