Table 3.
Models for initial and confirmatory testing of CD
| Model | Initial test | Additional tests if initial test positive | Definitive test |
|---|---|---|---|
| A |
TG2 IgA |
None |
Biopsy |
| B |
TG2 IgA |
HLA-DQ |
Biopsy if HLA-DQ2.5/2.2/8+ |
| C |
TG2 IgA |
EMA and HLA-DQ |
Biopsy if HLA-DQ2.5/2.2/8+ |
| D |
TG2 IgA |
If TG2 IgA > 10 × ULN, then EMA and HLA-DQ; otherwise none |
None if TG2 IgA > 10 × ULN, EMA abnormal and HLA-DQ2.5/2.2/8+; otherwise biopsy |
| E |
HLA-DQ |
TG2 IgA; if TG2 IgA 1 to 3 × ULN, then EMA |
Biopsy if TG2 IgA >3 × ULN or EMA abnormal |
| F |
Composite TG2/DGP IgA/IgG |
None |
Biopsy |
| G |
Composite TG2/DGP IgA/IgG |
HLA-DQ |
Biopsy |
| H | Composite TG2/DGP IgA/IgG | HLA-DQ, TG2 IgA, DGP-G and DGP-A | Biopsy if HLA-DQ2.5/2.2/8+ and either TG2 IgA or DGP-G or DGP-A abnormal |
Abbreviations: DGP, Deamidated gliadin-derived peptide; EMA, endomysial antibody; HLA, human leukocyte antigen; TG, transglutaminase; ULN, upper limit of normal.