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Test ID CDCOM Celiac Disease Comprehensive Cascade, Serum and Whole Blood

Useful For

Evaluating patients suspected of having celiac disease, including patients with compatible symptoms, patients with atypical symptoms, and individuals at increased risk (family history, previous diagnosis with associated disease)

 

Comprehensive algorithmic evaluation including human leukocyte antigen typing

Method Name

IGA: Nephelometry

CELI2: Polymerase Chain Reaction (PCR)/Sequence-Specific Oligonucleotide Probe (SSO)

CDCM1: Technical Interpretation

Reporting Name

Celiac Disease Comprehensive Casc

Specimen Type

Serum
Whole Blood ACD-B


Ordering Guidance


This cascade should not be used in patients who have previously been or are currently being treated with a gluten-free diet. For these individuals, CDGF / Celiac Disease Gluten-Free Cascade, Serum and Whole Blood should be ordered.

 

This cascade should not be used in patients for whom human leukocyte antigen (HLA) DQ2/DQ8 typing has already been performed. For individuals who are positive for either DQ2 and/or DQ8, CDSP / Celiac Disease Serology Cascade, Serum should be ordered to assess for the presence of autoantibodies associated with celiac disease. For individuals who are negative for DQ2 and DQ8, no further testing is necessary as a diagnosis of celiac disease is unlikely.

 

Cascade testing is recommended for celiac disease. Cascade testing ensures that testing proceeds in an algorithmic fashion. The following cascades are available; select the appropriate one for your specific patient situation.

-CDCOM / Celiac Disease Comprehensive Cascade, Serum and Whole Blood: Complete testing including HLA DQ

-CDSP / Celiac Disease Serology Cascade, Serum: Complete serology testing excluding HLA DQ

-CDGF / Celiac Disease Gluten-Free Cascade, Serum and Whole Blood: For patients already adhering to a gluten-free diet

 

To order individual tests, see Celiac Disease Diagnostic Testing Algorithm



Specimen Required


Both blood and serum are required.

 

Specimen Type: Blood

Container/Tube: Yellow top (ACD solution A or B)

Specimen Volume: 6 mL

Collection Instructions: Send whole blood in original tube. Do not aliquot.

 

Specimen Type: Serum

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 2 mL

Collection Instructions: Centrifuge and aliquot serum into a plastic vial.


Specimen Minimum Volume

Blood: 3 mL
Serum: 1.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 14 days
  Frozen  21 days
Whole Blood ACD-B Refrigerated (preferred)
  Ambient 

Reference Values

IMMUNOGLOBULIN A (IgA)

0-<5 months: 7-37 mg/dL

5-<9 months: 16-50 mg/dL

9-<15 months: 27-66 mg/dL

15-<24 months: 36-79 mg/dL

2-<4 years: 27-246 mg/dL

4-<7 years: 29-256 mg/dL

7-<10 years: 34-274 mg/dL

10-<13 years: 42-295 mg/dL

13-<16 years: 52-319 mg/dL

16-<18 years: 60-337 mg/dL

≥18 years: 61-356 mg/dL

 

HLA-DQ TYPING

Presence of DQ2 or DQ8 alleles associated with celiac disease

Day(s) Performed

Profile tests: Monday through Friday; Reflex tests: Monday through Saturday

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

81376 x 2

82784

86258 (if appropriate)

86364 (if appropriate)

86231 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CDCOM Celiac Disease Comprehensive Casc 94493-4

 

Result ID Test Result Name Result LOINC Value
IGA Immunoglobulin A (IgA), S 2458-8
DQA DQ alpha 1 94495-9
28991 Celiac Disease Interpretation 69048-7
DQB DQ beta 1 53938-7
CELIG Celiac gene pairs present? 48767-8

Test Classification

See Individual Test IDs

Profile Information

Test ID Reporting Name Available Separately Always Performed
IGA Immunoglobulin A (IgA), S Yes Yes
CELI2 HLA-DQ Typing Yes, (Order CELI) Yes
CDCM1 Celiac Disease Interpretation No Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
EMA Endomysial Abs, S (IgA) Yes No
DAGL Gliadin(Deamidated) Ab, IgA, S Yes No
TTGG Tissue Transglutaminase Ab, IgG, S Yes No
DGGL Gliadin(Deamidated) Ab, IgG, S Yes No
TTGA Tissue Transglutaminase Ab, IgA, S Yes No

Testing Algorithm

If the IgA result is within the age-specified normal range, then tissue transglutaminase (tTG) IgA antibody will be performed at an additional charge.

 

If tTG IgA antibody result is equivocal, then endomysial IgA antibodies and deamidated gliadin IgA antibody testing will be performed at an additional charge.

 

If IgA is greater than or equal to 1.0 mg/dL but lower than age-specified normal, then tTG IgA, tTG IgG, deamidated gliadin IgA, and deamidated gliadin IgG antibody testing will be performed at an additional charge.

 

If IgA is below the limit of detection (<1.0 mg/dL), then tTG IgG and deamidated gliadin IgG antibody testing will be performed at an additional charge.

 

For more information see Celiac Disease Comprehensive Cascade Test Algorithm

Report Available

7 to 14 days

NY State Approved

Yes

Forms

If not ordering electronically, complete, print, and send Gastroenterology and Hepatology Test Request (T728) with the specimen