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Test ID CDCOM Celiac Disease Comprehensive Cascade, Serum and Whole Blood

Useful For

Evaluating patients suspected of having celiac disease, including patients with compatible symptoms, patients with atypical symptoms, and individuals at increased risk (family history, previous diagnosis with associated disease)

 

Comprehensive algorithmic evaluation including HLA typing

Reporting Name

Celiac Disease Comprehensive Casc

Specimen Type

Serum
Whole Blood ACD-B


Advisory Information


This cascade should not be used in patients who have previously been or are currently being treated with a gluten-free diet. For these individuals, CDGF / Celiac Disease Gluten-Free Cascade should be ordered.

 

This cascade should not be used in patients for whom HLA DQ2/DQ8 typing has already been performed. For individuals who are positive for either DQ2 and/or DQ8, CDSP / Celiac Disease Serology Cascade should be ordered to assess the levels of autoantibodies associated with celiac disease. For individuals who are negative for DQ2 and DQ8, no further testing is necessary as a diagnosis of celiac disease is unlikely.

 

Cascade testing is recommended 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.

-CDCOM / Celiac Disease Comprehensive Cascade: complete testing including HLA DQ

-CDSP / Celiac Disease Serology Cascade: complete testing excluding HLA DQ

-CDGF / Celiac Disease Gluten-Free Cascade: for patients already adhering to a gluten-free diet

To order individual tests, see Celiac Disease Diagnostic Testing Algorithm in Special Instructions.



Specimen Required


Both blood and serum are required.

 

Specimen Type: Blood

Container/Tube: Yellow top (ACD [solution B])

Specimen Volume: 6 mL

Collection Instructions: Do not transfer blood to other containers.

 

Specimen Type: Serum

Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 2 mL


Specimen Minimum Volume

Blood: 3 mL
Serum: 1.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 14 days
  Frozen  21 days
Whole Blood ACD-B Refrigerated (preferred)
  Ambient 

Reference Values

IMMUNOGLOBULIN A (IgA)

0-<5 months: 7-37 mg/dL

5-<9 months: 16-50 mg/dL

9-<15 months: 27-66 mg/dL

15-<24 months: 36-79 mg/dL

2-<4 years: 27-246 mg/dL

4-<7 years: 29-256 mg/dL

7-<10 years: 34-274 mg/dL

10-<13 years: 42-295 mg/dL

13-<16 years: 52-319 mg/dL

16-<18 years: 60-337 mg/dL

≥18 years: 61-356 mg/dL

 

HLA-DQ TYPING

Presence of DQ2 or DQ8 alleles associated with celiac disease

Day(s) and Time(s) Performed

IgA, tTG IgA, Gliadin IgA, tTG IgG, Gliadin IgG: Monday through Saturday; 3 p.m.

HLA-DQ Typing: Monday through Friday; 7:30 a.m.-5 p.m.

Endomysial antibodies: Monday through Friday; 7 a.m.-5 p.m.

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

82784

81376 x 2

83516-Deamidated gliadin IgA (if appropriate)

83516-Deamidated gliadin IgG (if appropriate)

83516-tTG IgA (if appropriate)

83516-tTG IgG (if appropriate)

86255-Endomysial antibodies (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CDCOM Celiac Disease Comprehensive Casc 94493-4

 

Result ID Test Result Name Result LOINC Value
IGA Immunoglobulin A (IgA), S 2458-8
DQA DQ alpha 1 94495-9
28991 Celiac Disease Interpretation 69048-7
DQB DQ beta 1 53938-7
CELIG Celiac gene pairs present? 48767-8

Test Classification

See Individual Test IDs

Profile Information

Test ID Reporting Name Available Separately Always Performed
IGA Immunoglobulin A (IgA), S Yes Yes
CELI2 HLA-DQ Typing Yes, (Order CELI) Yes
CDCM1 Celiac Disease Interpretation No Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
EMA Endomysial Abs, S (IgA) Yes No
DAGL Gliadin(Deamidated) Ab, IgA, S Yes No
TTGG Tissue Transglutaminase Ab, IgG, S Yes No
DGGL Gliadin(Deamidated) Ab, IgG, S Yes No
TTGA Tissue Transglutaminase Ab, IgA, S Yes No

Testing Algorithm

If IgA is age-specified normal, then tissue transglutaminase (tTG) IgA will be performed at an additional charge.

 

If tTG IgA is equivocal, then endomysial antibodies IgA and deamidated gliadin antibody IgA will be performed at an additional charge.

 

If IgA is greater than or equal to 1.0 mg/dL but lower than age-specified normal, then tTG IgA, tTG IgG, deamidated gliadin IgA, and deamidated gliadin IgG will be performed at an additional charge.

 

If IgA is below detection (<1.0 mg/dL), then tTG IgG and deamidated gliadin IgG will be performed at an additional charge.

 

The following algorithms are available in Special Instructions:

-Celiac Disease Comprehensive Cascade

-Celiac Disease Diagnostic Testing Algorithm

-Celiac Disease Gluten-Free Cascade

-Celiac Disease Routine Treatment Monitoring Algorithm

-Celiac Disease Serology Cascade

NY State Approved

Yes

Forms

If not ordering electronically, complete, print, and send a Gastroenterology and Hepatology Client Test Request (T728) with the specimen.