Friday, March 25, 2016

Diagnosis of celiac disease

So today, we were discussing differentials of weight loss when someone mentioned celiac disease. What tests do you usually order to diagnose celiac disease?

We answered:
IgA endomysial antibody (IgA EMA)
IgA tissue transglutaminase antibody (IgA tTG)
IgA deamidated gliadin peptide (IgA DGP)

But there is something else which also needs to be ordered if these tests are negative. Do you know what it is?

IgA levels! Why?

Because in patients with selective IgA deficiency, you might get a false negative.

In patients in whom low IgA or selective IgA deficiency is identified, IgG-based testing should be performed which includes IgG tissue transglutaminase antibody (IgG tTG) and IgG deamidated gliadin peptide (IgG DGP) [1]

That's all!

Quote for the day: Decide what to be and go be it :)


Related posts:

[1] Diagnosis and Management of Celiac Disease
Alberto Rubio-Tapia, Ivor D. Hill, et-al, Am J Gastroenterol 2013; 108:656–676; doi:10.1038/ajg.2013.79

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