Celiac Disease Reflexive Cascade

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Example Reports
Negative
Positive
Ordering Recommendation

Preferred reflex screening test for celiac disease and dermatitis herpetiformis. May aid in monitoring adherence to gluten-free diet.

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

Effective February 16, 2016

Test Number
 Components
 Reference Interval
0050340 Immunoglobulin A Effective February 16, 2016
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: 68-408 mg/dL

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 IgA 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
3 U/mL or less Negative
4-10 U/mL Weak Positive
11 U/mL or greater Positive

0050736 Endomysial Antibody, IgA by IFA Less than 1:10
0056009 Tissue Transglutaminase Antibody, IgG
5 U/mL or less Negative
6-9 U/mL Weak Positive
10 U/mL or greater Positive

Interpretive Data

Refer to report.

Compliance Category

FDA

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 https://www.arupconsult.com/Algorithms/CeliacDz.pdf. Additional charges apply.

Hotline History
N/A
CPT Codes

82784; if reflexed additional CPT codes may apply: 83516, 83516 x2 and/or 86256.
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 is greater than or equal to the normal age range, add 83516; if reflexed, add 86256 and 83516.

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Components
Component Test Code* Component Chart Name LOINC
0050340 Immunoglobulin A 2458-8
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
Aliases
Celiac Disease Reflexive Cascade