Celiac disease is an autoimmune digestive disease that damages the villi of the small intestine and interferes with absorption of nutrients from food. People who have celiac disease cannot tolerate gluten, a protein in wheat, rye, and barley. Villi normally allow nutrients from food to be absorbed through the walls of the small intestine into the bloodstream. Without healthy villi, a person becomes malnourished, no matter how much food one eats. The disease is common, occurring in about 1% of the population, but 97% of celiac sufferers remain undiagnosed. Symptoms vary from mild nonspecific symptoms to clear gastrointestinal symptoms such as diarrhea, abdominal pain, bloating accompanied by symptoms of malabsorption such as nutrient deficiency, weight loss, and anemia.
Complete testing for celiac disease. The comprehensive panel is a package of all celiac disease antibody tests. Most doctors --being pressured by insurance companies to cut costs -- do not order the comprehensive panelfor their patients. Testing algorithms vary among doctors which may only order t-Transglutaminase (tTG) IgA and Immunoglobulin A as an initial screen.
Deamidated gliadin peptide (DGP) antibodies measure the level of immune response towards derivatives of gliadin. Gliadin is a component of gluten. A newly introduced test, it replaced in clinical use the older and less accurate antigliadin-antibodies (AGA) test.
Tissue Transglutaminase (tTG) antibodies target transglutaminase, an enzyme found in all organs, but of great importance in the small intestine where it is responsible for normal tissue function and maintenance. Decrease of tTG in the small intestine leads to an an inflammatory process damages the villi.
Anti-Endomysial Antibodies (EMA) attack the endomysium (a membrane surrounding muscle fibers) of the small intestine. The antigen identified in this process is Tissue Transglutaminase. Both tests essentially detect the same target, but through different methodologies.
Immunoglobulin A (IgA) is the total quantity of IgA antibodies. Active in mucous tissues including the small intestine, IgA antibodies -DGP IgA and tTG IgA are most accurate for detecting celiac disease in most people. However, 10% of celiac disease patients do not produce IgA antibodies and will test negative for DGP Iga and tTG IgA. In such case, the diagnostic burden is placed on IgG andtibodies and small intestinal biopsy.
Exclude the possibility of Celiac Disease. Genetics is a necessary factor for celiac disease. Genes that make one susceptible to celiac disease are carried by about one third of the population, but only about 3% of those actually go one to develop the disease. If the genetic variant does not exist, it is impossible for someone to have celiac disease or develop it in the future. This test is useful in cases where the patient is already on a gluten free diet or to asses if a patient with celiac disease in the family has inherited the genes.