tTG-IgA is the most sensitive and specific single test for celiac disease in patients who are eating gluten. The body produces these antibodies when gluten triggers immune-mediated damage to the small intestine. Levels typically fall with strict gluten-free diet adherence.
This test is used to screen patients with symptoms suggestive of celiac disease (diarrhea, weight loss, anemia, growth failure in children), evaluate family members of patients with celiac disease, and monitor adherence to a gluten-free diet. It must be performed while the patient is consuming gluten — testing during a gluten-free diet may produce false negatives. Total IgA should be measured alongside, since selective IgA deficiency can cause false-negative results. Sample type is serum.