Test Code TTGG Tissue Transglutaminase Antibody, IgG, Serum
Reporting Name
Tissue Transglutaminase Ab, IgG, SUseful For
For individuals with IgA deficiency:
Evaluating patients suspected of having celiac disease, including patients with compatible clinical symptoms, patients with atypical symptoms, and individuals at increased risk (family history, previous diagnosis with associated disorder, positivity for HLA DQ2 and/or DQ8
Screening test for dermatitis herpetiformis, in conjunction with an endomysial antibody test
Monitoring response to gluten-free diet in patients with dermatitis herpetiformis and celiac disease
Testing Algorithm
The following algorithms are available:
-Celiac Disease Comprehensive Cascade Test Algorithm
-Celiac Disease Diagnostic Testing Algorithm
-Celiac Disease Gluten-Free Cascade Test Algorithm
Performing Laboratory
Mayo Clinic Laboratories in RochesterSpecimen Type
SerumOrdering Guidance
Cascade testing is recommended for celiac disease. Cascade testing ensures that testing proceeds in an algorithmic fashion. The following cascades are available; select the appropriate one for your specific patient situation.
-CDCOM / Celiac Disease Comprehensive Cascade, Serum and Whole Blood: complete testing including HLA DQ
-CDSP / Celiac Disease Serology Cascade, Serum: complete serology testing excluding HLA DQ
-CDGF / Celiac Disease Gluten-Free Cascade, Serum and Whole Blood: for patients already adhering to a gluten-free diet
To order individual tests, see Celiac Disease Diagnostic Testing Algorithm.
Specimen Required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Specimen Minimum Volume
0.4 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 21 days | |
Frozen | 21 days |
Special Instructions
Reference Values
<6.0 U/mL (negative)
6.0-9.0 U/mL (weak positive)
>9.0 U/mL (positive)
Reference values apply to all ages.
Day(s) Performed
Monday through Saturday
Test Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
86364
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
TTGG | Tissue Transglutaminase Ab, IgG, S | 56537-4 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
TTGG | Tissue Transglutaminase Ab, IgG, S | 56537-4 |
Interpretation
Positive results for tissue transglutaminase (tTG) IgG antibodies are consistent with a diagnosis for celiac disease, particularly in individuals who are IgA deficient. For individuals with moderately to strongly positive results, a diagnosis of celiac disease is possible and a small intestinal biopsy should be considered to confirm the diagnosis.
Negative results for tTG IgG antibodies indicate a decreased likelihood of celiac disease.
A decrease in the concentration of tTG IgG may begin after initiation of a gluten-free diet and could indicate a response to therapy.
Clinical Reference
1. Rubin JE, Crowe SE: Celiac disease. Ann Intern Med. 2020 Jan;172(1):ITC1-ITC16. doi: 10.7326/AITC202001070
2. Lebwohl B, Rubio-Tapia A: Epidemiology, presentation, and diagnosis of celiac disease. Gastroenterology. 2021 Jan;160(1):63-75. doi: 10.1053/j.gastro.2020.06.098
3. Rubio-Tapia A, Hill ID, Kelly CP, Calderwood AH, Murray J, American College of Gastroenterology: ACG clinical guidelines: Diagnosis and management of celiac disease. Am J Gastroenterol. 2013 May;108(5):656-76; quiz 677. doi: 10.1038/ajg.2013.794.
4. Penny HA, Raju SA, Sanders DS: Progress in the serology-based diagnosis and management of adult celiac disease. Exp Rev Gastroenterol Heptatol. 2020 Mar;14(3):147-154. doi: 10.1080/17474124.2020.1725472
Report Available
Same day/1 to 4 daysMethod Name
Enzyme-Linked Immunosorbent Assay (ELISA)
Forms
If not ordering electronically, complete, print, and send a Gastroenterology and Hepatology Test Request (T728) with the specimen.