Celiac Disease - Diagnosis Algorithm

IgA TTG has high sensitivity and specificity of ~ 98% and is the best serologic marker for evaluating CD.

IgA deficiency affects 2%–3% of CD patients.

If IgA def ---> check IgG deamidated gliadin peptide

First degree relatives have inc risk of celiac. As do pts with DM1, Down’s, Turner’s, and Williams’ syndromes. 

Ruling out celiac in pts with IBS-D is recommended.

In pts already on a GFD--> check HLA DQ2 or DQ8 to identify which pts need further testing. 

-A negative test essentially rules out celiac. 

-A positive test however, does not establish a diagnosis  since this can be seen in the general population.



- Gastroenterology Review @GIreview



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