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Gluten-Related Disorders and Gluten Free Diet Plan
The initial test is immunoglobulin A (IgA) anti-tissue transglutaminase (TTG) antibody in patients over 2 years old. If this serology is positive, the patient should proceed to an endoscopic small bowel biopsy of the duodenum. If a patient has a typical symptoms and high probability of celiac disease, the physician may advise to proceed directly to a small bowel biopsy. A positive biopsy will have a pathology showing lymphocytes within the epithelium, hypertrophy of crypts, and diminished villous height. A genetic test is also available which determines susceptibility of the patient to celiac disease.
Additional testing of routine complete blood count may show anemia and nutrient testing might reveal vitamin and mineral deficiencies. Basic metabolic panel may show electrolyte abnormalities related to malabsorption. Liver function tests may be elevated.
