Celiac Disease Diagnosis Algorithm

The Celiac Disease Algorithm is utilized to streamline the serological testing for the diagnosis of celiac disease. The algorithm initially orders a serum IgA. Depending on the IgA result, further testing is reflexively ordered and processed. If the serum IgA is very low (<6 mg/dL), transglutaminase IgG AB (TTGG) and deamidated gliadin IgG AB (GLADG) are automatically performed. If the serum IgA low (>6, but below age matched reference range), transglutaminase IgG and IgA antibody tests (TTGG, TTGA), and deamidated gliadin IgG and IgA antibody tests (GLADG, GLADA) are reflexively performed. If the initial serum IgA result is normal or elevated, transglutaminase IgA AB (TTGA) is performed. If the transglutaminase IgA AB is negative (<15) or positive (>30), no further testing is performed. Testing is complete. If the transglutaminase IgA AB is weakly positive (15-30), endomysial IgA AB (EMA) and deamidated gliadin IgA AB (GLADA) testing are reflexively performed.