Celiac HLA DQ Association

CPT: 81377; 81383
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Test Details

Synonyms

  • HLA DQ2
  • HLA DQ8
  • HLA Typing (DQ2, DQ8)

Use

Aids in the diagnosis of celiac disease. The HLA DQ Association test provides genotyping for detection of HLA-DQ2 (DQA1*05:01 or 05:05 and DQB1*02:01 or 02:02) and HLA-DQ8 (DQB1*03:02). Patients with DQ2, half DQ2 and/or DQ8 are predisposed to celiac disease. A negative result essentially rules out celiac disease. In addition to DQ2 and DQ8 status, the report also includes complete DQA and DQB genotypes, homozygosity for DQB1*02, and genetic risk assessment.

Limitations

The HLA DQ Association test detects celiac disease-associated alleles that predispose to the disorder but is not diagnostic of celiac disease. More than 95% of celiac disease patients are positive for DQ2, half DQ2, or DQ8, but many individuals with these genetic results do not develop celiac disease. Even with appropriate precautions, an occasional specimen may not be satisfactory for testing. In such cases, fresh specimens should be collected for retesting.

Methodology

Polymerase chain reaction (PCR)/sequence-specific oligonucleotide probes (Luminex®)

This is a class II antigen level and an allele level test.

Additional Information

Celiac disease is an autoimmune disorder characterized by a well defined genetic predisposition and sensitivity to gluten (found in wheat, barley and rye) that causes inflammation in the small intestine, villous atrophy, and malabsorption. Celiac disease can present with gastrointestinal symptoms and/or widely variable non-gastrointestinal findings such as iron deficiency anemia, dermatitis herpetiformis, osteoporosis, chronic fatigue, short stature, neurologic symptoms, and many more. Gastrointestinal symptoms are present in fewer than 50% of cases of systematic celiac disease. Strict avoidance of gluten in the diet will rid inflammation in most cases, and celiac-associated antibodies are likely to disappear with time.

Celiac disease affects approximately 1% of the US population, but only about 17% of cases are currently diagnosed. Underdiagnosis is likely due to the variable presentation of celiac disease and clinical overlap with numerous other disorders such as IBS. The prevalence of celiac disease in increased in certain autoimmune disorders such as insulin-dependent diabetes(~6%),thyroiditis (~2% to 4%) and Sjogren syndrome (~5%). It is also increased in Down syndrome (5% to 12%), Turner syndrome (~3%), Williams syndrome (3% to 10%) and selective IgA deficiency (~2% to 10%).

Genetic predisposition to celiac disease requires the presence of specific variants of the human leukocyte antigen (HLA) class II genes HLA-DQA1 and HLA-DQB1 to be present. These genes encode the alpha and beta chains of the celiac-associated proteins DQ2 and DQ8. Presence of DQ2, half DQ2 and/or DQ8 is required but not sufficient for the development of celiac disease. One or more of these HLA results are present in 30% of the population but overall, only 3% of these individuals develop celiac disease. The risk for developing celiac disease increases when there is a first degree relative with celiac disease (eg. the risk approaches 40% for sibs with the same HLA genotype as a patient with celiac disease).

Specimen Requirements

Specimen

Whole blood or buccal swabs

Volume

7 mL or four buccal swabs

Minimum Volume

3 mL or four buccal swabs

Container

Lavender-top (EDTA) tube or four buccal swabs in a sealed envelope (buccal swab kit). If submitting buccal swabs, please use the kit provided by LabCorp. To obtain the buccal swab kit or to discuss other specimen types, please telephone 800-533-1037.

Storage Instructions

Maintain specimen at room temperature. Protect from extreme heat or cold.

Causes for Rejection

Incorrect specimen container (tube type); yellow-top (ACD) tube

Clinical Information

Special Instructions

If you have questions, please telephone HLA customer service at 800-533-1037 for assistance in selecting the appropriate HLA test for the patient.

References

Green PHR, Cellier C. Celiac disease. N Engl J Med. 2007:357:1731-174317960014
Pietzak MM, Schofield TC, McGinnis MF, Nakamura RM. Stratifying risk for celiac disease in a large at-risk United States population by using HLA alleles. Clin Gastroenterol Hepatol. 2009 Sep;7:966-971.19500688
Sapone A, Bai JC, Ciacci C, et al. Spectrum of gluten-related disorders: Consensus on new nomenclature and classification. BMC Med. 2012 Feb;10:13.22313950
Taylor AK, Lebwohl B, Snyder C, Green PHR. Celiac Disease. In: Pagon RA et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2016. 2008 Jul 3 [updated 2015 Sep 17].20301720

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
167082 Celiac Disease HLA DQ Assoc. 167083 DQ2 (DQA1 0501/0505,DQB1 02XX) 4935-3
167082 Celiac Disease HLA DQ Assoc. 167084 DQ8 (DQA1 03XX, DQB1 0302) 41283-3
167082 Celiac Disease HLA DQ Assoc. 167085 Comment: 49549-9
167082 Celiac Disease HLA DQ Assoc. 167137 Additional Information: 48767-8
167082 Celiac Disease HLA DQ Assoc. 167086 QC N/A

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