Deamidated Gliadin Abs, IgA
Other names: GLIADIN (DEAMIDATED) AB (IGA)
What Are Deamidated Gliadin Peptide (DGP) Antibodies?
Deamidated gliadin peptide (DGP) antibodies, measured as IgA or IgG (anti-DGP), are blood tests used in the evaluation of suspected celiac disease. These antibodies help detect an abnormal immune response to gluten and are particularly useful in situations where standard celiac tests may be less reliable.
When DGP Testing Is Helpful
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Young children (<2 years old): Anti-DGP may be positive even when tissue transglutaminase (tTG) antibodies are negative, making it useful for early detection.
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IgA deficiency: The American College of Gastroenterology recommends DGP IgG, along with tTG IgG, for patients with low IgA or IgA deficiency.
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Monitoring disease activity: In diagnosed patients, anti-DGP levels can be followed over time to assess response to a gluten-free diet.
About Celiac Disease
Celiac disease is an autoimmune disorder in which the immune system reacts abnormally to gluten (a protein found in wheat, barley, and rye). This immune reaction damages the lining of the small intestine, leading to inflammation, villous atrophy, and nutrient malabsorption.
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Affects both children and adults; prevalence is estimated at up to 1% of the U.S. population.
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Can also present as dermatitis herpetiformis, a blistering, itchy skin rash.
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Treatment requires lifelong strict gluten avoidance, which allows antibody levels to decline and the intestine to heal.
Although the gold standard for diagnosis remains a small intestine biopsy, antibody testing—such as anti-DGP—offers a less invasive way to identify individuals at risk before biopsy is considered.
When Celiac Tests Are Ordered
Celiac antibody testing is often ordered when symptoms, nutrient deficiencies, or family history suggest the condition.
Digestive symptoms
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Abdominal pain, bloating
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Chronic diarrhea or constipation
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Foul-smelling, greasy stools
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Vomiting or excessive gas
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Bloody stools (rare)
Non-digestive symptoms
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Iron-deficiency anemia unresponsive to supplements
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Fatigue, weakness, easy bruising
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Bone or joint pain, osteoporosis
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Dental enamel defects, mouth ulcers
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Unexplained weight loss
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Infertility in adults
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Growth delay or failure to thrive in children
Risks of Untreated Celiac Disease
If not recognized and treated, celiac disease may lead to:
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Chronic malnutrition
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Osteoporosis and fractures
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Infertility and pregnancy complications
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Neurological issues (neuropathy, ataxia)
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Dermatitis herpetiformis
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Increased risk of intestinal lymphoma and other cancers
Follow-Up and Monitoring
For patients with a celiac diagnosis, antibody testing (including DGP) may be repeated to:
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Confirm declining antibody levels after starting a gluten-free diet
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Support evaluation of intestinal healing (sometimes confirmed by repeat biopsy)
Who Else Might Be Tested?
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First-degree relatives of people with celiac disease, even if asymptomatic
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Individuals with unexplained nutrient deficiencies, anemia, or other autoimmune conditions
Routine screening of the general population is not currently recommended.
What does it mean if your Deamidated Gliadin Abs, IgA result is too high?
What Do Elevated Celiac Antibody Levels Mean?
Elevated DGP antibodies (IgA or IgG), especially when combined with positive tTG or EMA results, strongly suggest celiac disease. However, interpretation depends on which antibodies are elevated and whether total IgA levels are normal.
Interpreting Elevated Celiac Antibody Results
| tTG-IgA | Total IgA | tTG-IgG | DGP-IgA | DGP-IgG | Possible Interpretation |
|---|---|---|---|---|---|
| Positive | Normal | Not done | Not done | Not done | Strong evidence for celiac disease |
| Negative | Normal | Negative | Negative | Negative | Symptoms not likely due to celiac disease |
| Negative | Low/Deficient | Positive | Negative | Positive | Possible celiac disease (false negatives on IgA-based tests due to IgA deficiency) |
| Negative | Normal | Negative | Positive | Positive or not done | Possible celiac disease (common in children <3 years old) |
| Positive | Normal or Low | Positive | Positive | Positive | Highly suggestive of celiac disease; biopsy usually recommended |
Next Steps After Elevated Antibodies
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Biopsy confirmation: All positive or indeterminate antibody results are usually followed by an intestinal biopsy, the gold standard for diagnosis.
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Gluten-free diet impact: If you are already gluten-free, antibodies may appear falsely low or negative. Doctors may recommend a gluten challenge (temporarily reintroducing gluten) before retesting.
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Monitoring: In diagnosed patients, antibodies should decline on a strict gluten-free diet. Persistent elevation may suggest hidden gluten exposure or, rarely, refractory celiac disease.
Risks of Untreated Celiac Disease
If left untreated, celiac disease can lead to:
-
Chronic malnutrition
-
Osteoporosis and fractures
-
Infertility or pregnancy complications
-
Neurological issues (neuropathy, ataxia)
-
Dermatitis herpetiformis
-
Increased risk of intestinal lymphoma and other cancers
Who Else Might Be Tested?
Testing may be recommended for:
-
First-degree relatives of people with celiac disease (parents, siblings, children)
-
Individuals with unexplained nutrient deficiencies, anemia, or other autoimmune conditions
Routine screening of the general population is not currently recommended.
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