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Test ID RTA Reticulin Antibodies, Serum

Reporting Name

Reticulin Abs, S

Useful For

Investigation of celiac disease (CD)

 

Reticulin antibodies are no longer considered useful in the diagnosis of CD. Mayo Medical Laboratories recommends ordering TTGA / Tissue Transglutaminase (tTG) Antibody, IgA, Serum or EMA / Endomysial Antibodies (IgA), Serum for evaluation of patients suspected of CD or dermatitis herpetiformis.

Specimen Type

Serum


Specimen Required


Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 0.5 mL


Specimen Minimum Volume

0.2 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred) 14 days
  Frozen  14 days

Reference Values

Negative

If positive, results are titered.

 

Reference values apply to all ages.

Day(s) and Time(s) Performed

Monday through Sunday; 11 a.m.

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

86255-Screen

86256-Titer (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
RTA Reticulin Abs, S 57414-5

 

Result ID Test Result Name Result LOINC Value
9275 Reticulin Abs, S 57414-5

Clinical Information

Celiac disease (CD) is a genetically inherited autoimmune digestive disease and tends to occur in families of European descent. Family members of people with CD or dermatitis herpetiformis are at increased risk of CD.

 

CD is characterized by a permanent intolerance to gluten. When gluten is ingested, the immune system triggers an isolated inflammatory response in the small intestinal mucosa.

 

A lifetime gluten-free diet can completely stop the immune response. Once the patient is on a gluten-free diet, the small intestine begins to repair itself and the antibody levels decline and eventually disappear. However, reintroduction of gluten-containing products stimulates the immune response again. A significant reduction in morbidity and mortality occurs when patients adhere to the gluten-free diet.

 

Patients with CD produce various autoantibodies, including endomysial (EMA), tissue transglutaminase (tTG), gliadin, and reticulin antibodies, as part of the immune response. IgA antibodies usually predominate although patients may also produce IgG autoantibodies. The levels of these antibodies decline following institution of a gluten-free diet.

 

tTG is the primary autoantigen recognized by EMA antibodies in patients with CD and is currently considered the most useful first level screening test for CD. Reticulin antibodies are no longer considered useful in the diagnosis of CD because they lack the sensitivity and specificity of the EMA and tTG tests.

 

Serological screening offers a minimally invasive option for rapid identification of those likely to have CD and to select those who should be subjected to biopsy. Markedly positive (serologically) individuals are highly likely to have CD and should undergo biopsy to confirm the diagnosis.

Interpretation

Decreasing titers suggest successful avoidance of gluten.

Clinical Reference

1. Murray JA: The widening spectrum of celiac disease. Am J Clin Nutr 1999;69:354-365

2. Lazzari R, Volta U, Bianchi FB, et al: R1 reticulin antibodies: markers of celiac disease in children on a normal diet and on gluten challenge. J Pediatr Gastroenterol Nutr 1984;3:516-522

Analytic Time

2 days

Method Name

Indirect Immunofluorescence

Forms

If not ordering electronically, complete, print, and send a Gastroenterology and Hepatology Test Request Form (T728) with the specimen (http://www.mayomedicallaboratories.com/it-mmfiles/gastroenterology-and-hepatology-test-request.pdf)