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Diagnostic Testing Algorithms for Celiac Disease



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Summary

Slide 11

updated June 2011

To summarize the diagnostic algorithm, testing for total IgA is useful in identifying individuals with IgA deficiency. For this sub-group of individuals, testing for specific antibodies of the IgA isotype is of little use.

The purpose of the TTG and deamidated gliadin antibody tests is to identify individuals with suspected celiac disease. These are the individuals in whom a small intestinal biopsy is most warranted. One caveat to this testing strategy is that TTG and deamidated gliadin antibody titers generally decrease when a patient has been following a gluten-free diet.

For the HLA typing, although a positive result does not confirm a diagnosis of celiac disease, a negative result, meaning that both DQ2 and DQ8 alleles are absent, essentially rules out the diagnosis. This may be of use in individuals with equivocal serologic and/or biopsy results.

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