Celiac Disease Serology Cascade, Serum - Mayo Clinic Laboratories Rochester

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, positivity for DQ2 and/or DQ8)

Special Instructions

Method Name

Nephelometry

Reporting Name

Celiac Disease Serology Cascade

Specimen Type

Serum

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 individual who are negative for DQ2 and DQ8, as a diagnosis of celiac disease is unlikely. For individuals who are positive for either DQ2 and/or DQ8, this test may be ordered to assess the levels of autoantibodies associated with celiac disease.

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

Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 2 mL

Specimen Minimum Volume

1.5 mL

Specimen Stability Information

Specimen Type	Temperature	Time	Special Container
Serum	Refrigerated (preferred)	14 days
	Frozen	21 days

Reference Values

Immunoglobulin A

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

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

82784

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
CDSP	Celiac Disease Serology Cascade	94494-2

Result ID	Test Result Name	Result LOINC Value
IGA	Immunoglobulin A (IgA), S	2458-8
28991	Celiac Disease Interpretation	69048-7

Test Classification

See Individual Test IDs

Profile Information

Test ID	Reporting Name	Available Separately	Always Performed
IGA	Immunoglobulin A (IgA), S	Yes	Yes
CDSP1	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 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