Help interpreting test results
 

Hi:

My sons did a serum test about two months after implementing a gluten free diet. The results were as follows:

deamidated gliadin IgA 1.0 (ref 0-10)
deamidated gliadin IgG 1.0 (ref 0-10)
t-transglutaminase IgA 1.0 (ref 0-3)
t-transglutaminase IgG 9 HIGH (weak positive 6-9, positive >9)
endomysial antibody IgA negative
immunoglobulin A 105 (ref 27-195)

I would appreciate an interpretation of these test results. Thanks for your help!

Amy

Celiac Disease
 

I too had lab work done to determine if I am suffering from Celiac disease. These are the results of the test. Can anyone tell me what they could mean?

TISSUE TRANSGLUTAMINASE IGG 0.19 <0.90- Index
TISSUE TRANSGLUTAMINASE IGA 0.28 <0.90- Index

Thanks,
Leanne

Hi Amy,

The immunoglobulin A test is looking for a condition called IgA deficiency. Some people don't make any or enough IgA and in those circumstances other IgA antibody testing is not reliable. Your son is not IgA deficient; he tested in normal range for total IgA. All other tests are normal except for the positive t-transglutaminase IgG (aka anti-tTG IgG).

The positive t-transglutaminase IgG is significant and probably indicates celiac disease is present. In general, a positive anti-tTG IgA has a positive predictive predictive rate in the neighborhood of 95-98%. I'm not sure if the anti-tTG IgG rate is quite as high, but it is still considered a positive test for celiac disease.

Good thing he didn't wait any longer to have the blood work done after beginning a gluten free diet because the antibodies can drop off rather quickly. So, he might have had even more positive results had he done the blood work prior to beginning the diet. IgA class antibodies drop off faster than IgG antibodies, so that might explain why he didn't get a positive anti-tTG IgA but still showed a positive anti-tTG IgG.

Hopefully he and his doctor will see the anti-tTG IgG as enough proof of celiac disease to remain gluten free for life.

Often, a GI will want to perform an intestinal biopsy to confirm the diagnosis. Again, there is the problem of beginning the diet prior to the testing. Biopsy results may not be an accurate indicator in someone who has already started the diet.

If your son has already started the diet, and particularly if he has noticed any improvement already... it might make more sense to continue to move forward on the diet rather than be talked into a gluten challenge of consuming gluten again for 8 weeks to be biopsied. It will be interesting to see whether his doctor takes a practical approach or a textbook approach. Also, you can be gluten sensitive without showing biopsy damage needed for a celiac diagnosis, so even if your son ended up with a negative biopsy... given his isolated positive blood test after two months, I would encourage him to remain gluten free. My guess is he would have also shown positive to antigliadin (AGA) IgG which is an indicator of gluten sensitivity had it been run. It has been replaced with the deamidated gliadin antibody, which isn't quite the same.

You can read more about the various antibody tests used in diagnostic testing here:
https://sites.google.com/site/jccglu...gnostictesting

Let us know what the doctor say about the results he got. Did a GI or primary care doctor order the blood work? Was your son very symptomatic? With typical or atypical symptoms?

Hi Leanne,
These tests are both negative, but please do not consider it the end of the story.

You can definitely have gluten sensitivity causing serious health problems without testing positive for celiac disease via the above antibody tests, and without a positive intestinal biopsy. The blood tests mentioned above represent a very bare bones version of the complete celiac panel, for one thing.

Read more about diagnostic testing here:
https://sites.google.com/site/jccglu...gnostictesting
https://sites.google.com/site/jccglu...ndstooltesting

Read more about gluten sensitivity vs. celiac disease here:
https://sites.google.com/site/jccglu...sceliacdisease


You have several options:

1) Seek further testing.

You could request the antigliadin (AGA) IgA and IgG test. It is a much more sensitive test for identifying gluten sensitivity. Be sure it is the antigliadin AGA and NOT the deamidated gliadin DGP test that is ordered. Request a total IgA testto rule out IgA deficiency.

or

Test through Enterolab which is a stool test that looks for antibodies to gluten in the stool rather than the blood. It is considered a much more sensitive test for diagnosing gluten sensitivity. Enterolab testing cannot diagnose celiac disease. Stool testing is still considered an "alternative" test, but many physicians are beginning to use this test.


2) Begin a gluten free dietary trial and see if you enjoy any symptomatic improvement.

I'm not sure what your symptoms are, but you should know that about half of those with gluten sensitivity also have casein sensitivity. Many people have problems with other grains, too, not just wheat, barley and rye. If you opt to go with a dietary trial you might want to start with a no grain, no dairy diet for a couple of months and see if you improve. There is tons of information on a Paleolithic Diet on the Internet. It is tricky, because if you have trouble with several foods, but only remove gluten, you may not see the improvement.

3) You could have some food allergy testing done.

Not only traditional IgE food allergy testing but also delayed (IgG) food allergy testing. This can help to pinpoint other foods you may need to eliminate. I've known many people who had good results removing foods determined by IgG food allergy testing. There are several labs that do this testing.. .some are listed on the right bar here:
https://sites.google.com/site/jccglutenfree/foodallergy


You haven't mentioned what your symptoms are but food sensitivity, whether gluten sensitivity alone, or multiple food sensitivities, can wreak havoc on your health even in the absence of celiac disease. Don't give up on this avenue of "food" being culprit for your health problems until you've taken a more thorough look and done some dietary trials.

Hope this helps!

Thank you so much for your insight!

I have identical twins and the test results were the same for both. We took the blood test two years ago. We have been gluten free since then and decided not to do the biopsy. My sister was diagnosed with celiac disease >20 years ago but I never knew that it could be hereditary. After I had the boys' bloodwork done, I decided to do the Enterolab test for me, my husband, my mom and my dad. Results came back for all four of us above normal ranges (especially for my mom) for gluten and casein. I also had an older sister who died at the age of 5 due to intestinal complications. I wonder if she too had celiac disease. The autopsy report indicates "areas of chronic and acute inflammation" in the intestines and "total loss of mucosal structure" in the colon. Genetics for us were: 0202, 0503 (H), 0202, 0301 (F), 0303, 0501 (M) and 0203, 0303 (me). At the time that we did the testing, I couldn't find much information about anti-tTG IgG, so I appreciate your comments.

We recently sent in an intestinal permeability test for the boys, me and my husband to see to what extent the gut may still be compromised. I'll be interested in seeing what it says.

Amy

Celiac test result
 

I have celiac and had my son tested. Here are his results.

Immunoglobulin A 272
Gliadin IGA Deamidated 132
Gliadin IGG Deamidated 71
Transglutaminase IGA 54
Translut IGG 3

Would these results suggest that he tested positive for Celiac?

Thanks,

Well, we would need the reference ranges and units--
 

--for each of the tests, but if these are measured in the usual way, I would say yes.

The immunoglobulin IgA levels are withing normal limits--low levels there can skew the test results, usually in a false negative direction--and the gliadin and transglutaminase levels, if measured in the usual ng/Dl way (perhaps you can confirm this for us) seem pretty high.

Celiac Blood Test Results
 

Below is the full picture we received. It appears to me that 4 of the 5 categories reflect a positive result for Celiac. Because this is life changing, I just want to be sure. We haven't heard back from the doctor yet and the waiting is always uncomfortable.

Immunoglobulin A 272 range 91-414
Gliadin IGA Deamidated 132 range 0-19
Negative 0 - 19
Weak Positive 20 - 30
Moderate to Strong Positive >30

Gliadin IGG Deamidated 71 range 0-19
Negative 0 - 19
Weak Positive 20 - 30
Moderate to Strong Positive >30

Transglutaminase IGA 54 range 0-3
Negative 0 - 3
Weak Positive 4 - 10
Positive >10

Translut IGG 3 range 0-5
Negative 0 - 5
Weak Positive 6 - 9
Positive >9

Yes--
 

--given the ranges, that's a rather unequivocal positive result.

Time to get him off gluten. (What are your son's symptoms/complaints?)

It is life-changing, yes, but do-able. If you have celiac, you know this--and know that the biggest difficulties are in eliminating non-obvious sources of gluten that sneaks into foods, cosmetics, etc., beyond eliminating obvious wheat/rye/barley sources.

iga test results
 

Can someone help me in reading these test results?

Sufficient IGA present
Negative <20 units
indeterminate 20-30 units
Positive > 30 units

IGA 122.55
Tiss transglutamin iga 3