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HelpTest Code CDCOM Celiac Disease Comprehensive Cascade, Serum and Whole Blood
Reporting Name
Celiac Disease Comprehensive CascUseful 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
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
Specimen Type
SerumWhole 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.
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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.
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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 | |||
Special Instructions
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
Test Classification
See Individual Test IDsCPT 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 |
Report Available
7 to 14 daysReject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | OK |
Method Name
IGA: Nephelometry
CELI2: Polymerase Chain Reaction (PCR)/Sequence-Specific Oligonucleotide Probe (SSO)
CDCM1: Technical Interpretation
Forms
If not ordering electronically, complete, print, and send Gastroenterology and Hepatology Test Request (T728) with the specimen