A celiac panel refers to a collection of blood tests that measure a patient's immune response to gliadin and other medical concerns. This panel is also commonly referred to as a Celiac Blood Panel or even a Celiac Cascade. One of the more important aspects of a celiac panel is it can determine whether or not a patient is eligible for further diagnostic testing.
What to Expect from a Celiac Panel
A celiac blood panel is not a conclusive test for celiac disease. It represents one of the first steps a medical practitioner may take to uncover whether or not a patient is likely to harbor gluten intolerance. You can consult the Mayo Clinic's Celiac Cascade diagram to get an idea of what is involved in this series of blood tests, but for the most part, an eligible patient will be tested for antibodies specific to gliadin. Gliadin is the real offender within a gluten-molecule. In fact, most cases of gluten intolerance could be more accurately labeled as gliadin intolerance.
A celiac panel may also include genetic tests for celiac disease that determine whether or not an individual is genetically predisposed to the condition. Again, such bloodwork will not provide a patient with a conclusive celiac diagnosis, but should the individual in question prove genetically susceptible, this provides grounds for further testing.
Though not conclusive, a celiac panel is a necessary step towards diagnosis. The gold-standard conclusive diagnostic tool for celiac disease is the intestinal biopsy. However, this procedure is invasive and individuals who show little indication of celiac disease in their bloodwork may be spared a costly surgical procedure. There are risks associated with an intestinal biopsy, though they are not terribly common. Still, the preparations for surgery combined with the medical costs incurred during and post-operative are no small matter.
Celiac disease produces symptoms very similar to other digestive conditions such as inflammatory bowel disease and even the ever-common Irritable Bowel Syndrome. This is why a blood test can be a handy tool in isolating celiac disease from the horde of alternative conditions that generate like symptoms. Hence, although a patient will not receive a categorical diagnosis following his blood panel, what a celiac panel can do is isolate the patient's case from microbial causes or any other kinds of misdiagnosis.
The Accuracy of Blood Tests
A positive celiac blood panel can move a patient in the right diagnostic direction, but, unfortunately, such blood tests are not always accurate. For starters, some patients simply do not produce significant antibodies for their gliadin IgA test. These atypical cases can lead a doctor onto the wrong path. This is why the celiac panel has been expanded to include more than a gliadin antibody test. Inaccurate tests represent the rarer cases.
Furthermore, an individual who has already begun a gluten-free diet prior to their testing may throw off the panel results. It is important for patients to be consuming a normal gluten-containing diet weeks before the blood work begins in order to produce the most accurate results.
You can review details regarding the accuracy of a typical celiac panel at CSACeliacs.org, though it is important to remember that these serologic tests are not standardized and may vary depending on your doctor or laboratory.
The cost of a celiac panel for patients who do not have insurance will average anywhere from $250 to $500 (U.S.). Some hospitals or laboratories will offer payment plans in order to make these tests more affordable for lower income families. Do keep in mind that should your celiac panel be positive, your doctor may recommend the costly intestinal biopsy procedure be delayed in favor of monitoring your results on a gluten-free diet. Though you will not achieve a categorical diagnosis through such measures, if gluten is the cause of your troublesome symptoms, you will have already begun a safe treatment.
Always discuss your financial concerns with your doctor before attempting to avoid the surgical biopsy. In some circumstances, an intestinal biopsy may still be necessary.