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.
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
0050340Immunoglobulin A
0-​30 days: 1-​7 mg/dL
1 month: 1-​53 mg/dL
2 months: 3-​47 mg/dL
3 months: 5-​46 mg/dL
4 months: 4-​72 mg/dL
5 months: 8-​83 mg/dL
6 months: 8-​67 mg/dL
7-​8 months: 11-​89 mg/dL
9-​11 months: 16-​83 mg/dL
1 year: 14-​105 mg/dL
2 years: 14-​122 mg/dL
3 years: 22-​157 mg/dL
4 years: 25-​152 mg/dL
5-​7 years: 33-​200 mg/dL
8-​9 years: 45-​234 mg/dL
10 years and older: 68-​378 mg/dL
0051689Celiac 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.
0051357Deamidated Gliadin Peptide (DGP) Antibody, IgA 19 Units or less: Negative
20-​30 Units: Weak Positive
31 Units or greater: Positive
0051359Deamidated Gliadin Peptide (DGP) Antibody, IgG 19 Units or less: Negative
20-​30 Units: Weak Positive
31 Units or greater: Positive
0097709Tissue Transglutaminase (tTG) Antibody, IgA 19 Units or less: Negative
20-​30 Units: Weak Positive
31 Units or greater: Moderate to Strong Positive
0050736Endomysial Antibody, IgA by IFA Less than 1:10
0056009Tissue 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
0050340Immunoglobulin A
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, contact interface support at interface.support@aruplab.com.
Cross References