Transcription of Celiac Disease Diagnostic Testing Algorithm
1 10/2018 mayo Foundation for medical Education and Research (MFMER). All rights reserved. Celiac Disease Diagnostic Testing AlgorithmTesting for selective IgA deficiencyIGA / Immunoglobulin A (IgA), SerumTTGA / Tissue Transglutaminase (tTG) Antibody, IgA, SerumIgA 1 mg/dL and below age-matched reference values TSTGP / Tissue Transglutaminase (tTG)Antibodies, IgA and IgG Pro le, Serum DGLDN / Gliadin (Deamidated) AntibodiesEvaluation, IgG and IgA, Serum< U/mLCeliac Disease very : ~10% of patients with celiacdisease are seronegativeIf Celiac Disease is highlysuspected, consider CELI / Celiac Associated HLA-DQ Alpha 1 and DQ Beta 1 DNA Typing, Blood DAGL / Gliadin (Deamidated)Antibody, IgA, Serum EMA / Endomysial Antibodies(IgA), SerumProceed to biopsySelective IgA deficiency* TTGG / Tissue Transglutaminase(tTG) Antibody, IgG, Serum DGGL / Gliadin (Deamidated)Antibody, IgG, SerumAny result positive or equivocalAll results normalCeliac Disease very.
2 ~10% of patients with celiacdisease are seronegativeIf Celiac Disease is highly suspected, consider CELI / Celiac Associated HLA-DQ Alpha 1 and DQ Beta 1 DNA Typing, Blood Biopsy results inconsistent with serologyCELI / Celiac Associated HLA-DQ Alpha 1 and DQ Beta 1 DNA Typing, Blood Not Celiac diseasePossible Celiac diseaseFollow-up patient for future development of Celiac Disease Possible false-positive tTG result Celiac Disease possible but unlikelyIf strong suspicion of Celiac diseaseremains, perform HLA / Celiac Associated HLA-DQ Alpha 1 and DQ Beta 1 DNA Typing, Blood Not Celiac diseasePossible Celiac diseaseCeliac Disease > U/mLNormal or elevated IgAIgA <1 mg/dL* For individuals with clinical symptoms suggestive ofrecurrent infections, suggest further evaluation forpossible primary immunode ciency:IGGS / IgG Subclasses, SerumIMMG / Immunoglobulins (IgG, IgA, and IgM), SerumPOSITIVEPOSITIVEfor DQ2 or DQ8 POSITIVEfor DQ2 or DQ8 POSITIVE(EMA positive and/or d-gliadin Units)NEGATIVENEGATIVENEGATIVENEGATIVE(E MA negative and d-gliadin < Units)
