Celiac Disease
Celiac Disease Diagnosis
A person seeking preliminary diagnosis of celiac disease must be consuming gluten. Specific antibody blood tests are used to identify the presence of celiac disease and are the initial step in screening and should include: IgA endomysial antibodies (EMA), IgA tissue transglutaminase (tTG), IgG tissue transglutaminase and Total IgA antibodies. It is essential that patients with positive antibody tests, and those with an IgA deficiency, have a small bowel biopsy to confirm the diagnosis and assess the degree of mucosal damage, which is performed endoscopically.
When serology and biopsy are inconclusive, testing for specific HLA (human leukocyte antigen) genes associated with celiac disease may be helpful in screening for CD. If these genes are NOT present, it is unlikely that the individual will develop CD. A positive HLA or genetic test, however, does not mean that the individual has the condition, as these genes are common in the general population. Patients should consult with an experienced physician to ensure proper diagnosis.
Dermatitis Herpetiformis (DH) is diagnosed by a biopsy of a skin lesion and staining for IgA in the tissues. More than 85% of DH patients have small-bowel sensitivity to gluten. Everyone with DH needs to follow a gluten-free diet.
