Deamidated Gliadin Antibodies, IgA
Code:16020|CPT:86258|LOINC:58709-7
| Includes | Deamidated Gliadin Abs, IgA |
|---|
Analysis details
Methodology
- Enzyme immunoassay (EIA)
Expected Turnaround Time
1–2 days
Special Instructions
- Avoid smoking for at least 30 minutes before the blood draw.
How to use
Deamidated Gliadin Antibodies, IgA (antigliadin IgA; DGP IgA) supports the diagnosis of celiac disease and dermatitis herpetiformis and assists in monitoring established disease. It is ordered during the initial assessment of suspected gluten-sensitive enteropathy and for objective assessment of adherence to a gluten-free diet over time. When used in combination with tissue transglutaminase IgA and endomysial antibody testing, diagnostic performance improves, particularly in individuals considered at increased risk.
Limitations
Gliadin is a component of gluten present in wheat, rye, barley, and some other cereals. In genetically predisposed individuals, exposure triggers a mucosal immune response that damages the small intestine and produces the malabsorption phenotype of celiac disease. Serologic assays for disease-associated antibodies, including deamidated gliadin IgA, support diagnostic evaluation; however, histologic confirmation by small-bowel biopsy remains the reference standard. Selective IgA deficiency—more common among patients with celiac disease—can yield false-negative results on IgA-based assays. Measuring total serum IgA and performing parallel IgG-based testing (eg, deamidated gliadin IgG) are recommended in this context. Endomysial IgA is highly specific, and antibodies to tissue transglutaminase are routinely interpreted alongside gliadin serology. Antibody titers typically decline with strict adherence to a gluten-free diet, allowing serology to assist in monitoring treatment and dietary compliance. The disease is strongly associated with HLA-DQ2 and HLA-DQ8, and first-degree relatives carry increased risk, supporting consideration of family screening.
| Reference interval | — |
|---|---|
| Indications | Workup of suspected celiac disease with gastrointestinal complaints such as chronic diarrhea, recurrent vomiting, or abdominal pain., Assessment of poor growth or failure to thrive in children., Evaluation of iron-deficiency anemia without an identified cause., Skin findings compatible with dermatitis herpetiformis., Mucocutaneous conditions reported with gluten sensitivity, including atopic dermatitis, angular cheilitis, or recurrent aphthous ulcers., Neurologic or metabolic complications of malabsorption, for example peripheral neuropathy, osteopenia, hypocalcemic tetany, or a bleeding tendency., Reproductive concerns potentially linked to celiac disease, including amenorrhea, infertility, or erectile dysfunction., Testing individuals who have a first-degree relative with celiac disease., Follow-up of known celiac disease to monitor disease activity and adherence to a gluten-free diet., Targeted screening in associated conditions: type 1 diabetes mellitus, Hashimoto thyroiditis, systemic connective tissue diseases, alopecia totalis, and Down syndrome. |
Specimen Requirements
| Specimen | Serum |
|---|---|
| Container | Red-top tube, no additive (serum) |
| Volume | 1 mL (min 0.3 mL) |
| Storage Instructions | Room temperature, Refrigerated, Frozen |
References
Burgin-Wolff A, Gaze H, Hadziselimovic F, et al. Antigliadin and antiendomysium antibody determination for coeliac disease. Arch Dis Child. 1991 Aug;66(8):941-947. PubMed 1819255
Collin P, Maki M, Keyrilainen O, Hällström O, Reunala T, Pasternack A. Selective IgA deficiency and coeliac disease. Scand J Gastroenterol. 1992 May;27(5):367-371. PubMed 1529270
Kelly CP, Feighery CF, Gallagher RB, Gibney MJ, Weir DG. Mucosal and systemic IgA antigliadin antibody in celiac disease: Contrasting patterns of response in serum, saliva, and intestinal secretion. Dig Dis Sci. 1991 Jun;36(6):743-751. PubMed 2032515
McMillan SA, Haughton DJ, Biggart JD, Edgar JD, Porter KG, McNeill TA. Predictive value for coeliac disease of antibodies to gliadin, endomysium, and jejunum in patients attending for jejunal biopsy. BMJ. 1991 Nov 9;303(6811):1163-1165. PubMed 1747612
Armstrong D, Don-Wauchope AC, Verdu EF. Testing for gluten-related disorders in clinical practice: the role of serology in managing the spectrum of gluten sensitivity. Can J Gastroenterol. 2011 Apr;25(4):193-197.
Pruessner HT. Detecting Celiac Disease in Your Patients. Am Fam Physician. 1998 Mar 1;57(5):1023-1034.
Sugai E, Nachman F, Váquez H, et al. Dynamics of celiac disease-specific serology after initiation of a gluten-free diet and use in the assessment of compliance with treatment. Dig Liver Dis. 2010 May;42(5):352-358.
Bhattacharyya R, Sharma N, Banerjee D. Design of peptide for immunodetection of IgA antigliadin antibody for the purpose of screening of celiac disease. Bioinformation. 2012;8(2):87-91.