Celiac & Gluten Sensitivity; bloodspot

Overview:

Celiac disease (CD) is often undiagnosed and is caused in genetically predisposed individuals by abnormal intestinal permeability and abnormal immune response to gluten, a protein complex found in wheat, barley, spelt and rye. The inflammatory autoimmune response damages the lining of the small bowel and is associated with diarrhea, bloating, fatigue, nutritional deficiencies, and systemic autoimmune conditions. Gluten sensitivity can cause similar symptoms but without the same level of tissue damage.

The Celiac & Gluten Sensitivity profile from Doctor’s Data helps differentiate between CD and gluten sensitivity by evaluating the serum titers of IgA and IgG for deamidated gliadin peptide, gliadin, and gluten. Detailed Information The Celiac & Gluten Sensitivity profile from Doctor's Data helps identify, and differentiate between Celiac disease (CD), non-Celiac gluten sensitivity (NCGS) and wheat allergy by evaluating the serum titers of IgA and IgG for tissue transglutaminase, deamidated gliadin peptide, gliadin, gluten and IgE for wheat.

Celiac disease (CD) is often undiagnosed and is caused in genetically predisposed individuals by abnormal intestinal permeability and abnormal immune response to gluten, a protein complex found in wheat, barley, spelt and rye. The inflammatory autoimmune response is associated with extreme damage to the lining of the small bowel and is associated with diarrhea, bloating, fatigue, nutritional deficiencies, and systemic autoimmune conditions. Although most commonly diagnosed in children, CD is often not expressed until later in life (delayed onset).

It has been hypothesized that a gradual or abrupt change in the gastrointestinal microbiome may be responsible for delayed on set. Non-Celiac gluten sensitivity (NCGS) can cause similar symptoms but without the same level of intestinal epithelial tissue damage. Antibody tests that indicate possible CD and NCGS will only be accurate if the patient is on a gluten-inclusive diet. The test is also useful for monitoring adherence to a gluten-free diet.

Celiac Disease CD may result in a variety of gastrointestinal (GI) and “extra-intestinal” symptoms. Common symptoms associated with CD include:
• GI – Diarrhea, steatorrhea, weight loss, bloating, flatulence, abdominal pain
• Systemic

• Fatigue
• Iron deficiency anemia
• Rashes and skin problems
• Peripheral neuropathy or ataxia
• Autoimmune arthritis or neurological conditions
• Failure to thrive (infants)
• Bone disease or loss of bone density
• Malnutrition
• Hormone and fertility problems
• Abnormal liver function tests

CD is also associated with other clinical disorders including thyroiditis, type I diabetes mellitus, Down syndrome, and IgA deficiency. Patients diagnosed with CD must remain on a gluten-free diet for life and avoid all gluten containing foods and grains (wheat, rye, spelt, barley).

This test is clinically useful for monitoring patient adherence to a gluten-free diet. Gluten is present in almost all processed foods and many beverages. A list of foods that may contain gluten or wheat can be found on our Hidden Sources of Gluten and Wheat page. Non-Celiac Gluten Sensitivity (NCGS) Individuals with NCGS are often spared the intestinal damage common in Celiac patients, but suffer from abdominal pain, bloating, diarrhea, constipation, and many “extra-intestinal” symptoms such as “foggy mind”, depression, ADHD-like behavior, headaches, bone or joint pain, and chronic fatigue when they have gluten in their diet.

There are many antigenic triggers (epitopes) in the gluten protein complex that have cytotoxic, immunomodulatory, and gut permeating properties. Immune cells activated in the sub-endothelial space in the gut circulate throughout the body. Up to 50% of NCGS patients may only test positive for IgG anti-gliadin antibodies when on a gluten-inclusive diet.

Wheat Allergy Wheat allergy is caused by an individual’s IgE antibody response to many classes of wheat proteins including; serine protease inhibitors, gliadins, glutelins, prolamins and gluten. Symptoms of a wheat allergy reaction can range from mild, such as hives, to severe, such as anaphylaxis. Wheat allergy symptoms are sometimes confused with those of CD/NCGS, but these conditions differ and testing for IgE antibodies to wheat can aid in making the proper diagnosis.

Performing Lab: DDINT