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Celiac Disease Comprehensive Panel Lab Test

CPT Code(s)

83516, 82784


Tissue Transglutaminase, IgA with Reflexes; Total IgA with Reflex

If the Tissue Transglutaminase IgA is positive, Endomysial Antibody Screen (IgA) will be performed at an additional charge (CPT code(s): 86255). If the Endomysial Antibody Screen (IgA) is positive, Endomysial Antibody Titer will be performed at an additional charge (CPT code(s): 86256).
If the Total IgA is less than the lower limit of the reference range, based on age, Tissue Transglutaminase IgG will be performed at an additional charge (CPT code(s): 83516).


Immunoassay (IA) Immunoturbidimetric Assay

Reference Range(s)

(tTG) Antibody, (IgA)

<4 U/mLNo antibody detected
≥4 U/mLAntibody detected

IgA, Serum
Cord Blood1-3 mg/dL
1 Month2-43 mg/dL
2-5 Months3-66 mg/dL
6-9 Months7-66 mg/dL
10-12 Months12-75 mg/dL
1-3 Years24-121 mg/dL
4-6 Years33-235 mg/dL
7-9 Years41-368 mg/dL
10-11 Years64-246 mg/dL
12-13 Years70-432 mg/dL
14-15 Years57-300 mg/dL
≥16 Years81-463 mg/dL

Clinical Significance

Celiac disease is caused by an immune response to gluten in genetically sensitive individuals. The diagnosis is largely based on a biopsy of the small intestine, but serologic tests also help support a diagnosis and may assist identification of patients who may require biopsy.
Tissue transglutaminase antibodies (tTG, IgA) is a marker with 95% sensitivity and specificity. Total IgA is measured because 2-3% of celiac disease patients are IgA deficient. Because tTG, IgA, and anti-Gliadin IgA tend to decrease in patients on a gluten-free diet, these markers are also used to assess dietary compliance.
The endomysial antibody (EMA, IgA) assay has high specificity for celiac disease and is used to confirm positive anti-tTG results.

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