Celiac Disease

Causes & Risk Factors

Celiac disease results from an immune reaction to gluten in genetically susceptible individuals:

•  Genetic susceptibility — certain genetic markers (HLA-DQ2/DQ8) are present in nearly all people with celiac disease, though having these markers alone does not mean a person will develop the condition.

•  Family history of celiac disease increases individual risk.

•  Gluten exposure — the disease is triggered specifically by dietary gluten in genetically susceptible individuals.

•  Certain autoimmune conditions (such as type 1 diabetes or autoimmune thyroid disease) are associated with increased celiac disease risk.

Symptoms & When to Test

Celiac disease can present with classic gastrointestinal symptoms or with more subtle, non-gastrointestinal features, making it sometimes challenging to recognize.

•  Chronic diarrhea

•  Abdominal bloating

•  Abdominal pain

•  Weight loss

•  Iron deficiency anemia

•  Fatigue

•  Poor growth in children

•  Nutritional deficiencies

When Should You Consider Testing?

Testing is appropriate for chronic gastrointestinal symptoms, unexplained iron deficiency anemia, unexplained nutritional deficiencies, poor growth in children, or in individuals with a family history of celiac disease or an associated autoimmune condition.

Why Tests Are Combined

tTG-IgA is used as the initial serological test because it offers a good balance of sensitivity and specificity for celiac disease, but Total IgA is tested alongside it because IgA deficiency (present in a small percentage of the population) can cause a false-negative tTG-IgA result.

In patients with IgA deficiency, IgG-based celiac testing is used instead, since relying on tTG-IgA alone in this situation would risk missing the diagnosis entirely.

EMA-IgA may be added as a highly specific supportive test in certain situations, since its high specificity can help increase diagnostic confidence, particularly when initial results are borderline or when confirmatory evidence is needed before considering more invasive testing such as biopsy.

Tests Available at NPL

Preparation requirements vary by specific test — please follow the instructions provided by your doctor or NPL for the tests ordered.

Home Sample Collection

NPL offers convenient home sample collection for Celiac Disease blood tests, so you don't need to visit a lab in person.

→ Book your test online, via the NPL app, or by calling +977 1 5970147 and select a convenient time slot for home sample collection.

→ A certified and experienced NPL phlebotomist visits your home at the scheduled time, following strict hygiene and safety protocols.

→ Your sample is transported under controlled, monitored conditions to NPL's NABL ACCREDITED UNDER ISO 15189:2022 laboratory for processing.

→ Your digital report is delivered securely to your phone or email, along with access to download and share it as needed.

When to See a Doctor

•  Chronic diarrhea, bloating, or abdominal pain

•  Unexplained iron deficiency anemia

•  Unexplained weight loss or nutritional deficiencies

•  Poor growth in a child

•  Family history of celiac disease or an associated autoimmune condition