Bea, as a point of clarification, when you say elevated IgA and IgG, do you mean antigliadin IgA/IgG, or
total IgA/IgG? It can be confusing, but I'm thinking you are referring to antigliadin antibodies...associated with gluten sensitivity.
About the only thing I've seen written in regard to HLA DQ1 and antigliadin antibodies is that Dr. Hadjivassiliou has found positive antigliadin antibodies in about 40% of his neurological patients, and HLA DQ1 in about 20% of his gluten sensitive neurological patients.
I keep waiting for something more on this and I do keep my eyes out for new publications....wishing someone would do some sort of exclusive study on HLA DQ1 and gluten sensitivity. My older daughter and I both have double copies of HLA DQ1. My two daughters both had only an isolated positive antigliadin IgG. Total IgA was only tested for my older daughter, and it was was below range. If total IgA or total IgG are below range, other IgA/IgG tests are not reliable (like antigliadin IgA or IgG tests). My antigliadin and anti-endomysial antibodies were negative. I have no idea about my total IgA.
I also read that HLA DQ1 is associated with narcolepsy. I even talked to one person who had narcolepsy that disappeared with a gluten free diet! That is the only other thing I've seen.
Bea, generally positive antigliadin antibodies IgG are dismissed by doctors as being non-specific. However, Dr. Hadjivassiliou, the authority on gluten sensitivity and neurological disease, tells us sometimes the antigliadin IgG antibodies are the only indicator of gluten sensitivity in patients who do not have biopsy proven celiac disease.
This article probably discusses it best:
Gluten sensitivity as a neurological illness, M Hadjivassiliou, et al.
But here are more of his articles:
Dr. Marios Hadjivassiliou
Here is an excerpt where he explains why antigliadin IgG antibodies should not be ignored:
Quote:
From: The Neurology of Gluten Sensitivity: Science vs. Conviction by Hadjivassiliou and Grunewald
"There is also confusion about the role antigliadin antibodies as a screening tool. Given that gluten sensitivity can exist without enteropathy, it is inappropriate to estimate sensitivity and specificity of these antibodies against the presence of enteropathy as the 'gold standard'. To assert that antigliadin antibodies lack specificity based on the fact that 10% of the healthy population may have them is a misconception. It is entirely plausible that 10% of the healthy population with circulating antigliadin antibodies have gluten sensitivity without recognized manifestations. The prevalence of coeliac disease itself is now recognized to be 20 times higher than what it was thought to be 20 years ago because most cases are clinically silent. It is important to realize that amongst the 10% antigliadin antibody positive people lurks those with 'silent' gluten sensitive enteropathy."
"It is ill-considered to suggest that antigliadin antibodies should not be used as a screening tool because they are found in “healthy” individuals. It is also irresponsible to suggest that neurological patients should not be screened for coeliac disease unless additional factors are present such as unexplained anaemia or evidence of malabsorption."
"Neurologic manifestations of gluten sensitivity are a scientific fact, not a theological issue. Whilst the debate continues, we owe it to our patients to screen them effectively for gluten sensitivity with the simple widely available antigliadin antibody test so that we do not in the meantime deprive them of a harmless but potentially effective treatment in the form of a gluten-free diet."
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But... to answer your question... several studies say that up to 20% of
biopsy proven celiacs have negative blood work. To me that says it is absolutely possible that those with gluten sensitivity and the non-celiac genes of HLA DQ1 might also have negative blood work. It is hard to identify those people, though, because the blood tests are negative and only rarely do people with DQ1 show biopsy evidence of celiac disease (only 1% of the 1% who have biopsy proven celiac disease have HLA DQ1). So... in the event of a negative biopsy and negative blood antibody tests... it requires a dietary trial on a leap of faith.. and listening to your body's response to the diet.
Another option is the stool testing by Enterolab that shows positive before blood antibody testing, but is not alternative testing.
Cara