Updates on Laboratory Testing and Clinical Diagnosis of Celiac Disease

Annually, millions of patients seek medical advice due to chronic gastrointestinal issues. One challenge for gastroenterologists is differentiating between highly prevalent functional disorders, such as irritable bowel syndrome (IBS), and immune-mediated conditions such as Celiac disease that require more aggressive management. Advancements in noninvasive serology-based diagnostic tests have reduced the need for invasive procedures. These developments simultaneously have created challenges with test utilization due to varying diagnostic accuracies and lack of guidance. Recently, there has been new recommendations for the laboratory testing and clinical diagnosis of celiac disease, including recommendations for biopsy-free diagnosis. During this presentation, current updates on analytical and clinical recommendations, developments in testing methodologies and strategies, including reflex algorithms, and gaps in the laboratory diagnosis and management of patients with celiac disease will be discussed. Laboratorians and healthcare providers may find the session informative to help mitigate inappropriate testing and optimize patient outcomes in suspected celiac disease patients.

Originally published on February 7, 2023

Lecture Presenter

Vijayalakshmi (Viji) Nandakumar, PhD, DABCC Assistant Professor University of Utah School of Medicine Medical Director, Immunology ARUP Laboratories

Dr. Vijayalakshmi (Viji) Nandakumar is a medical director of Immunology at ARUP Laboratories, and an assistant professor (clinical) of Pathology at the University of Utah School of Medicine. She received her master’s degree in biology from the University of Alabama at Birmingham and her doctorate in genetic molecular and cell biology from the Keck School of Medicine at the University of Southern California. Dr. Nandakumar completed a fellowship in clinical chemistry at the Mayo Clinic, a research fellowship in cellular and molecular immunology at Keck School of Medicine at the University of Southern California, and a research fellowship in infection and immunology at the Mayo Clinic. Dr. Nandakumar is certified by the American Board of Clinical Chemistry. Her research interests include autoimmune diseases, complement deficiency, and protein immunology.

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Objectives

After this presentation, participants will be able to:

• Recognize the utility and limitations of celiac disease markers in the diagnosis
• Discuss the latest guidelines for serology testing in celiac disease diagnosis including recommendations for biopsy-free diagnosis
• Discuss the current state of laboratory tests in the treatment and management of celiac disease

Sponsored by:

University of Utah School of Medicine, Department of Pathology, and ARUP Laboratories