Who should be tested for Celiac Disease?
The clinical presentation of celiac disease has many faces and, as a consequence, the disease is often misdiagnosed. In fact, the average time from disease to diagnosis is 11 years. Those afflicted may have classic gastrointestinal (GI) symptoms or may only exhibit extra-intestinal manifestations.

Even in absence of overt GI complaints, avoidance of gluten is imperative owing to the risk of lymphoma and other malignancies associated with celiac disease. Clinicians should therefore consider routine screening for patients with the following clinical indications:

Typical Celiac Indications:
Chronic diarrhea
Malabsorption
Abdominal distention
Unexplained weight loss
Atypical Celiac Indications
Type 1 diabetes
Anemia
Osteoporosis
Chronic fatigue
Autoimmune disorders
Gastrointestinal disorders
Dermatitis herpeteformis
Behavioral Changes
Irritable bowel syndrome
Infertility/Miscarriage
Neurological symptoms

Other high risk groups include: first degree relatives, siblings and those with Immunoglobulin A (IgA) deficiency.

Diagnosing Celiac Disease
Patients with celiac disease are 10-15 times more likely to have IgA deficiency. Testing for total IgA increases the diagnostic accuracy by ruling out false negative results in this cohort. IgA-tTG (Anti-Tissue Transglutaminase) and IgG-tTG enzymes are highly sensitive markers for identifying celiac disease. When IgA-tTG is positive, testing for IgA-Anti-endomysial Antibodies (IgA-EMA) is routinely performed. This further enhances the accuracy of the profile, and helps identify those with silent and latent forms of the disease.

Clinicians also have the option of testing two additional analytes;
- IgA Anti-gliadin Antibodies (IgA-AGA)
- IgG Anti-gliadin antibodies (IgG-AGA)
These antibodies can be performed as part of the initial diagnostic evaluation, or on their own to monitor compliance to a gluten free diet.

Treating Celiac Disease
Treatment requires life-long abstinence of gluten containing foods. With the need for such a restrictive diet, it is important to accurately determine who has the condition. The Celiac Profile from Genova Diagnostics incorporates the most advanced non-invasive markers along with traditional serological tests.