Login to South West London Pathology Services

If you have any queries about pathology consumables – you need a new account or you have a query about your order, please telephone 020 8266 6827. Forgotten your password

Coeliac antibodies

Category Immunology and PRU
Reporting frequency 5 working days

Additional information

Testing requirements:

One tube of clotted blood.

Patients must be on a gluten-containing diet, ideally for at least 6 weeks prior to testing, to avoid false-negative results.

Test utility:

Coeliac antibody tests are useful for diagnosis of coeliac disease.

Coeliac antibody tests should not be used alone to assess adherence to gluten-free diet (NICE guidance 2015).

Laboratory test information:

Test Frequency Turnaround time (working days) Clinical sensitivity* Clinical specificity*
IgA anti-TTG Daily 5 Children: 91% (85-95)

Adults: 96% (93-99)
Children: 86% (78-91)

Adults: 91% (90-92)
IgA anti-endomysial antibodies Daily 5 Children: 97% (94-99)

Adults: 85% (78-90)
Children: 76% (67-83)

Adults: 98% (98-99)
IgG anti-TTG antibodies Daily 5 No data No data
IgG anti-endomysial antibodies Daily 5 No data No data

*From NICE guidance, based on published literature (mean + 95% confidence intervals)

Testing  pathway:

All requests for coeliac antibodies will be tested for IgA anti-TTG antibodies.

Patients that are IgA-deficient are detected by a low background signal on the analyser and the laboratory will automatically confirm the total IgA concentration and test for IgG antibodies to TTG and to endomysium, in line with NICE guidance.

In certain circumstances, it may be helpful to test for HLA DQ2 and HLA DQ8. Coeliac disease rarely occurs in individuals who do not have these HLA types. Please contact Haematology if this testing is required.

Test results:

Positive antibody results are consistent with coeliac disease. However, further testing may be required to confirm this diagnosis eg duodenal biopsy. Patients must be on a gluten-containing diet when these further tests are done.

Negative antibody results are not suggestive of coeliac disease, as long as the patient has been on a gluten-containing diet for at least six weeks.

Coeliac disease:  An autoimmune condition where gut inflammation is triggered by eating gluten-containing foods in susceptible individuals.  Symptoms include abdominal discomfort, bloating, constipation or diarrhoea. Symptoms may also arise secondary to impaired absorption of nutrients in the gut. Rarely, an itchy rash may be seen on extensor surfaces eg elbows, knees, called dermatitis herpetiformis. Symptoms usually resolve if gluten is excluded from the diet.

Guidelines and further information:

 
External laboratories:

To refer samples for testing, please send at least 1ml serum to:

Protein Reference Unit, South West London Pathology, St George’s Hospital, Tooting SW17 0QT.

For prices and other enquiries, please contact the Immunology Manager: aimee.rhodes@nhs.net.

Lab Tests Online UK

Lab Tests Online - UK is a website written by practising laboratory doctors and scientists to help you understand the many clinical laboratory tests that are used in diagnosis, monitoring and treatment of disease.

Click here to go to Labtestsonline.org.uk

  • Search Tests

Latest news

July 1, 2022

Refurbished Immunology and ED laboratories at St George’s Hospital get official opening

This week, the newly refurbished Immunology and Emergency Department (ED) laboratories at St George’s Hospital were officially opened by Trust Managing Director Kate Slemeck and Chief Operating Officer Anne Brierley. A ribbon cutting was held at each laboratory and Kate and Anne were given a tour around the refurbished spaces by laboratory staff. The Immunology […]

Read more
June 24, 2022

HIV service at Croydon Hospital wins ‘Top Global Winner’ at the UNIVANTS awards

This week, it was announced that work to improve HIV outcomes at Croydon Hospital was awarded ‘Top Global Winner’ at the UNIVANTS 2021 awards. The work focused on the introduction of ‘opt-out’ HIV testing in the Emergency Department at Croydon Hospital, with a sustained rate of 97% over 18 months, setting an international gold standard. […]

Read more
June 20, 2022

Immunology services across south west London to be centralised at the Immunology Laboratory at St George’s Hospital

All Immunology services and tests are moving to the South West London Pathology (SWLP) Immunology Laboratory and Protein Reference Unit at St George’s Hospital, which will become the hub for immunology across south west London. Already one of the largest immunology services in the country, the team will be expanded further when immunology services and […]

Read more
May 16, 2022

Point of Care Testing (POCT) at St George’s gets first UKAS accreditation

Last month, the SWLP POCT team received the exciting news that after two years of hard work, the blood gas and glucose meter service at St George’s was given full UKAS accreditation. It is the largest and most complex POCT service in the country to receive full accreditation, which proved challenging for both the POCT […]

Read more