Aids in the diagnosis of Coeliac disease The Coeliac Profile is a blood test that uses widely accepted immunologic biomarkers to aid in the diagnosis of Coeliac disease (CD). The markers include Total IgA, Anti-Tissue Transglutaminase IgA (tTG IgA) and IgG (tTG IgG), Anti-Deamidated Gliadin IgA (DGP IgA) and IgG (DGP IgG), and reflex Anti-Endomysial IgA (EMA IgA). What is Coeliac Disease and when should testing be considered? Coeliac disease is defined as an autoimmune enteropathy of the small intestine, caused by exposure to dietary gluten in genetically pre-disposed individuals. In susceptible individuals, gluten ingestion generates an inflammatory reaction predominantly centered in the upper parts of the small intestine. This mucosal injury will eventually reduce the intestinal absorptive area and interfere with uptake of micronutrients.2 Conditions and symptoms associated with Coeliac disease1,3,4 Chronic diarrhoea with weight loss Steatorrhea Postprandial abdominal pain Bloating Malabsorption with nutrient deficiencies (iron, B12, calcium) Irritable bowel syndrome Elevated liver enzymes Cerebellar ataxia Peripheral neuropathy Type I Diabetes Autoimmune hepatitis Autoimmune thyroiditis Infertility Dermatitis herpetiformis Sjogren syndrome Addison's disease Parathyroid disorders Growth hormone deficiency Primary biliary cirrhosis Primary sclerosing cholangitis Testing should be performed while the patient is still on a gluten-containing diet.1 The exception is follow-up testing for monitoring treatment efficacy. Ordering the Profile The Coeliac Profile can be ordered as a stand-alone profile or ordered together with other profiles. Often times, clinicians will order several smaller profiles together in order to see a more complete picture of the patient's immune mediated response. Profiles that can be ordered together include: IgG Foods - 87 foods plus total IgE IgG Vegetarian - 21 foods plus total IgE IgG Spices - 24 spices plus total IgE IgE Food Antibodies - 19 foods plus total IgE IgE Moulds - 14 moulds plus total IgE IgE Inhalants - 14 inhalants specific to 18 North American geographic regions plus total IgE Coeliac Profile - Total IgA, tTG IgA & IgG, DGP IgA & IgG, EMA IgA What advantage does the Coeliac Profile offer compared to other diagnostics? Intestinal biopsy is considered the gold standard for the diagnosis of Coeliac disease. International guidelines suggest that measuring immunologic analytes and genetic markers are favored to increase detection of CD. The European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) introduced a revised guideline for CD in children based on the optimisation of antibody assays. According to this guideline, children can be diagnosed with CD without a duodenal biopsy when presenting with suspicious symptoms, a strongly elevated tTG-IgA (>10 confirmed cut-off value), confirmed by a positive EMA-IgA on a separate occasion, and positive genetic testing (HLA-DQ2 and /or HLA-DQ8).5 Genova does not offer the HLA-DQ2/DQ8 genetic markers. Genova offers an interpretive algorithm to aid in assessing likelihood of disease. How it works Consult Healthcare Provider Your provider will discuss your symptoms and help decide which test is right for you. Many specimen collections can be completed from the privacy of your home.Collect SamplesUse a calendar to plan for your collection. Follow instructions carefully and be sure to add important details about you and your specimens where indicated.Ship to LabShip specimens using the materials provided. Schedule time with your healthcare provider to review results and create a plan for your health. Specimen: Serum
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