Celiac disease is defined as a genetic, immune mediated enteropathy
that results in malabsorption
. The disease is characterized by
sensitivity to the proteins found in wheat, and to a lesser extent, barley and
rye. The National Institutes of Health reported in August of 2004 that the
prevalence of Celiac Disease is much greater than previous estimates, possibly
affecting as many as 3 million Americans, indicating that the disease is widely
Who should be tested for Celiac Disease?
The clinical presentation of celiac disease has many faces and, as a
consequence, the disease is often misdiagnosed. In fact, the average time from
disease to diagnosis is 11 years. Those afflicted may have classic
gastrointestinal (GI) symptoms or may only exhibit extra-intestinal
Even in absence of overt GI complaints, avoidance of gluten is imperative owing
to the risk of lymphoma and other malignancies associated with celiac disease.
Clinicians should therefore consider routine screening for patients with the
following clinical indications:
Patients with celiac disease are 10-15 times more likely to have IgA deficiency.
Testing for total IgA increases the diagnostic accuracy by ruling out false
negative results in this cohort. IgA-tTG (Anti-Tissue Transglutaminase) and
IgG-tTG enzymes are highly sensitive markers for identifying celiac disease.
When IgA-tTG is positive, testing for IgA-Anti-endomysial Antibodies (IgA-EMA)
is routinely performed. This further enhances the accuracy of the profile, and
helps identify those with silent and latent forms of the disease.
Clinicians also have the option of testing two additional analytes;
- IgA Anti-gliadin Antibodies (IgA-AGA)
- IgG Anti-gliadin antibodies (IgG-AGA)
These antibodies can be performed as part of the initial diagnostic evaluation,
or on their own to monitor compliance to a gluten free diet.
Treatment requires life-long abstinence of gluten containing foods. With the
need for such a restrictive diet, it is important to accurately determine who
has the condition. The Celiac Profile from Genova Diagnostics incorporates the most
advanced non-invasive markers along with traditional serological tests.
With all this and more, why guess about your health? Isn't it time you found
out what's going on in your body?
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