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

If--
 

--the IgA figure is for TOTAL IgA, that is well within reference range, and therefore the IgA transglutaminase figure of 3 is low and not an immediate indicator of celiac.

The tranglutaminase IgA is the blood test most closely associated with villous damage of frank celiac, but did they also test you for the IgA and IgG anti-gliadin antibodies (which are measures that are more sensitive, but less specific, and often will show in those with gluten sensitivity that is not, or at least not yet, causing noticeable intestinal damage)?

post is correct
 

The test should be administered for the best results, before the glutton free diet. ginnie:hug:

You can also ask your doctor to run the genetic test, if you haven't already. It is usually not covered by insurance but it helped confirm my dx. Good luck!

that particular test is neg, however doesn't mean you don't have celiac.

It is virtually impossible to have celiac unless you carry the HLA gene. The antibodies can be negative but it would be highly unusual (if ever) to not have the gene.

Except--
 

--the genes may not only include the HLA-DQ2 and DQ8 variants that are quoted by most old-line researchers.

As Cara has documented in the Gluten File, European researchers, particularly Dr. Hadijvassiliou, have evidence pointing to other genetic configurations, particularly the HLA-DQ1 subtype, as predisposing towards gluten sensitivity, with or without frank celiac, and this may often manifest neurologically rather than gastrointestinally.

Help with interpreting test results
 

Hi
I recently had a gluten test done to see if I am allergic to gluten. The results are as follows:

> TTG IgA 0.70 0.00-10.0 U/mL
TTG IgA is the most sensitive and specific test for Celiac
disease (Gluten sensitivity). If there is still a high
degree of clinical suspicion in this patient, please exclude
IgA deficiency. In IgA deficient patients TTG IgG should be
done. The antigliadin and anti-endomycium antibodies
are also available if further testing is required.

Can someone please help with letting me know what the results mean.
Thanks
Jamie

Jamie, you do understand that celiac is not an allergy?

Test Results
 

I have Celiac Disease & Hypothyroidism and have been gluten free for about 3 months. I had some tests ran and was wondering if someone could explain to me the results.
FERRITIN
FERRITIN 148 ng/mL 12/5/2013

TISSUE TRANSGLUT. AB, IgA
TISSUE TRANSGLUT. AB, IgA 22.5 AU/mL 12/5/2013
TTA INTERPRETATION Positive (>16.0 AU/mL) 12/5/2013

TSH
TSH 2.55 mIU/L 12/5/2013

IRON AND IRON BINDING CAP.
% TRANSFERRIN SATURATION 22 % 12/5/2013
IRON 100 ug/dL 12/5/2013
TOT. IRON BINDING CAPACITY 450 ug/dL 12/5/2013

25 HYDROXY VITAMIN D
25-HYDROXY VITAMIN D 25 ng/mL 12/5/2013
INTERPRETATION REFERENCE VALUES: 12/5/2013

Well, without the reference values--
 

--for the ferritin, iron binding capacity and Vitamin D, it's not easy . . .

Fortunately, I am familiar with the general reference ranges for these tests, and can say that the ferritin result depends on gender; if you are male that results is fairly well within range, but it female it is a little high. Similarly, your iron levels are pretty mid range, but the total iron binding capacity is very near the upper end of "normal" range, and the transferrin saturation is near the lower end of normal, especially, again, if you are male. This implies there is sufficient iron available but it is not being absorbed as efficiently as it could be.

You vitamin D levels would be considered low, and, of course, the anti-transglutaminase igA antibody levels are consistent with celiac disease.

The TSH is pretty much normal, but it would be more interesting if you had other TSH levels from the past to compare it with, to see if it has been gradually rising/falling or been pretty consistent.

Thanks, I am actually at female. I have had issues for years with my iron being low. I have been taking iron vitamins well over a year. I am starting vitamin d3 per my doctor. Even though I have been gluten free for 3 months I still sluggish. And was wondering how long it will take before I start feeling better.

Given that--
 

--the iron levels are fairly consistent with supplementation.

Have you had low iron levels with associated with anemia in the past? That is very common in celiacs, who have trouble absorbing iron due to the villious atrophy, but it is also not uncommon among women with heavy periods (with or without celiac).

It does look like you should be supplementing with Vitamin D (the D3 form, not D2--the former is much better absorbed, and available over the counter). We have a major Vitamin D thread in our vitamin and supplements forum to explain all this and dosing protocols:

http://neurotalk.psychcentral.com/showthread.php?t=1448

"Feeling better" is very subjective--but for many people it takes many months to 'normalize" after eliminating gluten--the villi don't heal and recover function quickly. And, you have to make sure you aren't getting inadvertently glutened from any source--even personal care products (toothpaste, shampoos) can contain gluten ("modified wheat starch", "binder", "thickener") and reading labels assiduously has to become second nature.

results
 

my igg was 1.56 standard is <=0.90
my iga was 0.35 standard is <=0.90

im lost lol waiting on dr to schedule the endoscopy and colonoscopy... wondering if this test means i have celiac disease :confused::D

What tests are you actually referring to?
 

Are you speaking of anti-gliadin IgG/IgA, anti=transglutaminase IgG/IgA, or total IgG/IgA?

Anti-gliadin IgG is often the first test to go outside the range with gluten sensitivity, but it's also the least specific test for celiac among those in a standard gluten panel. The anti-transglutaminase IgA is generally the one most correlated with actual intestinal damage, but even that one is negative in around 20 percent of those people who actually show confirmed villious damage on endoscopy.