CLIA Transglutaminase

There are several serological tests that are sensitive in the evaluation of celiac disease. Celiac sprue (Celiac disease, gluten-sensitive enteropathy) is an immune-mediated inflammatory process following ingestion of wheat, rye, or barley proteins that occurs in genetically susceptible individuals. The main symptoms include inflammatory changes in the small intestine mucosa, diarrhea, anemia, weight loss, and general disorders in somatic and mental development. Celiac disease cannot be confused with the (simple) gluten intolerance often connected with cow’s milk intolerance and intestinal mucosa changes but without activation of transglutaminase.

The most sensitive and specific serologic tests are tTG and deamidated gliadin antibodies. Positivity for tTG IgA and IgG antibodies indicate celiac disease and a small intestinal biopsy is recommended. Although the IgA isotype of these antibodies usually predominates in celiac disease, individuals may also produce IgG isotypes, particularly if the individual is IgA deficient.

The levels of anti-tTG tend to wane in the absence of gluten ingestion, therefore, these markers are useful to monitor adherence to a gluten-free diet.