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Table 3 Models for initial and confirmatory testing of CD

From: A novel serogenetic approach determines the community prevalence of celiac disease and informs improved diagnostic pathways

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
  1. Abbreviations: DGP, Deamidated gliadin-derived peptide; EMA, endomysial antibody; HLA, human leukocyte antigen; TG, transglutaminase; ULN, upper limit of normal.