We are pleased to announce that Awanui Labs is updating our approach to Coeliac disease testing. This update involves minor changes to the testing algorithm and the introduction of an e-ordering form.
The purpose of this initiative is to encourage testing in appropriate clinical scenarios and to facilitate the provision of adequate clinical details which assist in result interpretation and reporting. The e-ordering form is designed to provide the necessary information for the laboratory to reflex (“add on”) appropriate follow on testing which simplifies the process for requestors.
Another reason for this change is to align our testing strategy with recently updated health pathways and to streamline the process for biopsy free diagnosis of coeliac disease in paediatric patients (please note, this is only in place in certain regions, please refer to your local health pathways for further information).
- For most patients, the first test is the coeliac screen – this includes TTG IgA and total IgA
- The e-ordering form will prompt the requester to select whether the testing has been requested for diagnosis or monitoring.
- If the test has been requested for diagnosis, the form will prompt the following compulsory fields (see below fields).
- Some patients have a diagnosis of coeliac disease already and the testing may be requested for monitoring
- It is possible to simply select this option for this group of patients.
- Endomysial IgA antibodies are orderable in specific clinical situations and are not part of the standard coeliac screen
- This will mostly commonly be indicated when following the biopsy free diagnosis pathway in paediatric patients (refer to regional health pathways for further details). This will need to be requested on a separate blood sample to the initial coeliac screen.
- There are some further (uncommon) clinical scenarios where this testing is indicated, listed below.
- dGP IgG is less commonly indicated, but can be requested if the patient is IgA deficient
- This will automatically be added on in the laboratory if IgA deficiency is detected on the initial coeliac screen. There are other uncommon scenarios where this is indicated and these are normally gastroenterologist led.
- HLA DQ2/8 typing is only indicated in defined clinical situations and orderable by specific requesters
- Unless clinical details are provided (to reflect indications outlined in relevant health pathways), testing by other requesters will usually be declined.
The Eclair eOrdering form will go live on 5 May 2025. For any questions please contact the Awanui immunology laboratory on 04 381 5900.