Celiac Disease Reflexive Cascade
2008114
Ordering Recommendation
Preferred reflex screening test for celiac disease. Cascade contains all tests, including IgA levels necessary for initial serologic evaluation of celiac disease.
Mnemonic
CELIAC REF
Methodology
Quantitative Nephelometry/Semi-Quantitative Enzyme-Linked Immunosorbent Assay//Semi-Quantitative Indirect Fluorescent Antibody
Performed
Sun-Sat
Reported
2-6 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
Specimen Required
- Patient Preparation
- Collect
- Serum separator tube.
- Specimen Preparation
- Separate serum from cells ASAP or within 2 hours of collection. Transfer 2 mL serum to an ARUP Standard Transport Tube. (Min: 1 mL)
- Storage/Transport Temperature
- Refrigerated.
- Unacceptable Conditions
- Plasma. Contaminated, hemolyzed, grossly icteric or grossly lipemic specimens.
- Remarks
- Stability
- After separation from cells: Ambient: 8 hours; Refrigerated: 8 days; Frozen: 1 year (if frozen within 24 hours)
Reference Interval
| Test Number | Components | Reference Interval | ||
| 0050340 | Immunoglobulin A |
| ||
| 0051689 | Celiac Disease Dual Antigen Screen | 19 Units or less: Negative - No significant level of detectable IgA or IgG antibodies against human tissue transglutaminase or gliadin peptide. 20 Units or greater: Positive - Presence of IgA and/or IgG antibodies against human tissue transglutaminase and/or gliadin peptide; suggests possibility of certain gluten sensitive enteropathies such as celiac disease and dermatitis herpetiformis. | ||
| 0051357 | Deamidated Gliadin Peptide (DGP) Antibody, IgA | 19 Units or less: Negative 20-30 Units: Weak Positive 31 Units or greater: Positive | ||
| 0051359 | Deamidated Gliadin Peptide (DGP) Antibody, IgG | 19 Units or less: Negative 20-30 Units: Weak Positive 31 Units or greater: Positive | ||
| 0097709 | Tissue Transglutaminase (tTG) Antibody, IgA | 19 Units or less: Negative 20-30 Units: Weak Positive 31 Units or greater: Moderate to Strong Positive | ||
| 0050736 | Endomysial Antibody, IgA by IFA | Less than 1:10 | ||
| 0056009 | Tissue Transglutaminase Antibody, IgG | < 20 EU: None Detected 20-30 EU: Weakly Positive > 30 EU: Positive |
Interpretive Data
Refer to report.
Note
The Celiac Disease Reflexive Cascade begins with Immunoglobulin A. Depending on findings, one or more reflexive tests may be required in order to provide a clinical interpretation. Tests added may include Tissue Transglutaminase Antibody, IgA; Tissue Transglutaminase Antibody, IgG; Endomysial Antibody, IgA by IFA; Deamidated Gliadin Peptide (DGP) Antibody, IgA; Deamidated Glaidin Peptide (DGP) Antibody, IgG; and/or Celiac Disease Dual Antigen Screen. Refer to the Celiac Testing Algorithm found at http://www.arupconsult.com/Algorithms/CeliacDz.pdf. Additional charges apply.
CPT Code(s)
82784; If IgA less than7.0 mg/dL, add 83516 x2; If IgA greater than or equal to 7.0 mg/dL but is less than the normal age range, add 83516. If reflexed to tTG IgA and Gliadin IgA, add 83516 x 2. If Reflexed to tTG IgG and Gliadin IgG, add 83516 x2.; If IgA greater than or equal to the normal age range, add 83516. If reflexed, add 86256 and 83516.
Components
| Component Test Code* | Component Chart Name | LOINC |
|---|---|---|
| 0050340 | Immunoglobulin A | 2458-8 |
Aliases