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Epic Test Code LAB773 Reticulin Antibodies, Serum

Additional Codes

MML Code: RTA

LIS Code: RTCA

NY State Approved

Yes

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Reporting Name

Reticulin Abs, S

Method Name

Indirect Immunofluorescence

Specimen Stability Information

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


Advisory Information


Reticulin antibodies are not useful in the diagnosis of celiac disease (CD). For evaluation of patients suspected of CD or dermatitis herpetiformis Mayo Clinic recommends ordering 1 of the following:

-TTGA / Tissue Transglutaminase (tTG) Antibody, IgA, Serum

-EMA / Endomysial Antibodies (IgA), Serum



Specimen Required


Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 0.8 mL


Specimen Type

Serum

Specimen Minimum Volume

0.4 mL

Reference Values

Negative

If positive, results are titered.

 

Reference values apply to all ages.

Analytic Time

2 days

Day(s) and Time(s) Performed

Monday through Sunday; 11 a.m.

CPT Code Information

86255

86256 (if appropriate)

Reject Due To

Hemolysis

Mild OK; Gross reject

Lipemia

Mild OK; Gross reject

Icterus

Mild OK; Gross OK

Other

NA

Cautions

No significant cautionary statements

Specimen Retention Time

14 days

Interpretation

Decreasing titers suggest successful avoidance of gluten.

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.

Useful For

Investigation of celiac disease (CD)

 

Reticulin antibodies are not useful in the diagnosis of CD. See Advisory Information.

Forms

If not ordering electronically, complete, print, and send a Gastroenterology and Hepatology Client Test Request (T728) with the specimen.