Celiac Disease

Celiac disease is an autoimmune reaction to gluten that remains underdiagnosed. At Vibrant America, we offer a comprehensive panel to help you optimize your treatment outcomes by early detection.

About the disease

Celiac disease is a disorder characterized by intestinal malabsorption of nutrients due to sensitivity to the alcohol-soluble portion of gluten known as gliadin. Wheat, rye, barley, and to a lesser extent, oats contain this protein substance and can induce mucosal damage in the gut causing nonspecific villous atrophy of the small intestine mucosa. Most patients are asymptomatic. This disease has variable clinical manifestations that can lead to severe symptoms such as profound malabsorption, steatorrhea, and wasting. There are associations between celiac disease and Type I diabetes mellitus, thyroid disease and other autoimmune diseases.

Symptoms

Celiac Disease in Adults
  • Depression or anxiety
  • Iron-deficiency/anemia
  • Fatigue
  • Arthritis
  • Seizures or migraines
  • Bone loss or osteoporosis
  • Irregular menstrual periods
  • Infertility or recurrent miscarriage
  • Dermatitis herpetiformis (itchy skin rash)
  • Mouth Ulcers
  • Tingling or numbness in the hands and feet
  • Bone or joint pain
Celiac Disease in Children
  • ADHD
  • Failure to thrive
  • Delayed puberty
  • Short stature
  • Irritability
  • Defects of permanent teeth
  • Fatigue
  • Weight loss
  • Pale, foul-smelling or fatty stool
  • Abdominal pain and bloating
  • Chronic diarrhea
  • Vomiting

Genetic Disposition

Celiac disease has a genetic disposition and is most common in Caucasians of Northern European descent. First relatives of someone diagnosed with the disease have a 1 in 22 chance of having signs of the disease in their lifetime. Uncontrolled celiac disease predisposes patients to gut carcinomas and lymphomas.

Tests

Celiac Tests

Celiac disease tests are ordered when someone has signs and symptoms suggesting celiac disease, malnutrition, and/or malabsorption. The symptoms are often nonspecific and variable, making the disease difficult to spot. The symptoms may be mild for some time, going unnoticed, and then progressively worsen or occur sporadically.

  • Vibrant™ Anti-tTg IgA
  • Vibrant™ Anti-tTg IgG
  • Vibrant™ Anti-dGP IgA
  • Vibrant™ Anti-dGP IgG
  • Total IgA

Additional Tests

Other tests may be ordered to help determine the severity of the disease and the extent of the complications a person may experience, such as malnutrition, malabsorption, and the involvement of other organs. Tests may include:

  • CBC (complete blood count) to look for anemia
  • ESR (erythrocyte sedimentation rate) to evaluate inflammation
  • hs-CRP (High Sensitivity C-Reactive protein) to evaluate inflammation
  • CMP (comprehensive metabolic panel) to determine electrolyte, protein, and calcium levels, and to verify the status of the kidney and liver
  • Vitamin D and B12 and folate to measure vitamin deficiencies
  • Iron, iron binding capacity or transferrin, and ferritin to detect iron deficiency

Results

Results

If the test results indicate absence of antibodies tested for celiac disease, confirm your patient was eating a normal, gluten-containing diet for a least 3 weeks prior to testing. If not, the test results may have been compromised. If the patient was eating normally, there is a chance he/she has non-celiac gluten sensitivity.

Celiac Disease Test Interpretation

Celiac Disease Test Interpretation

References:

1. Leffler, D.A. & Schuppan, D. (2010). Update on serologic testing in celiac disease. Am J Gastroenterol. 105 (12):2520-4.

2. Volta U, Fabbri A, Parisi C, et al. Old and new serological tests for celiac disease screening. Expert Rev Gastroenterol Hepatol. 2010;4(1):31-35.

3. Leffler, D.A. (2011). Celiac disease diagnosis and management: A 46-year-old woman with anemia. JAMA, 306(14), 1582-1592.

4. Prince, H.E. (2006). Evaluation of the INOVA diagnostics enzyme-linked immunosorbent assay kits for measuring serum immunoglobulin G (IgG) and IgA to deamidated gliadin peptides. Clin Vaccine Immunol, 13, 594-151.

5. Kumar, V., Jarzabek-Chorzelska, M., Sulej, J., Karnewska, K., Farrell, T., & Jablonska, S. (2002). How Celiac Disease and Immunoglobulin A Deficiency: How Effective Are the Serological Methods of Diagnosis? Clinical and Vaccine Immunology, 9(6), 1295-1300.

References: Allergy

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3. Sampson HA. Improving in vitro tests for the diagnosis of food hypersensitivity. Curr Opin Allergy Clin Immunol. 2002 Jun; 2(3):257-261. PubMed 12045424

4. Sampson HA. Utility of food-specific IgE concentrations in predicting symptomaticfood allergy. J Allergy Clin Immunol. 2001 May; 107(5):891-896. PubMed 11344358

5. Sampson HA, Ho DG. Relationship between food-specific IgE concentrations and the risk of positive food challenges in children and adolescents. J Allergy Clin Immunol.5997 Oct; 544(8):888-451.PubMed9338535