Confused by my blood work results

[kg51]

32F with a lifetime of various digestive upsets, but nothing that's ever been super severe, and nothing that's been consistent throughout. I had a panel done through my primary care doctor and the results popped up in my online account. While I wait to hear back from her (though I'm a little doubtful of her knowledge and will follow up with a GI regardless)...

Immunoglobin A: 216 (range 70-312)

Gliad (Deanidated) Ab IgG: negative

Gliad Deanidated) Ab IgA: negative

Endomysial Antibody IgA by IF: negative <1:10 (range <1:10)

Tissue Transglutaminase Ab IgA: 19.8 (range <15)

Tissue Transglutaminase IgA Qualitative: positive

So I understand that testing the immunoglobin A is to make sure it's normal to rule out the potential for false negatives. Then IgG and IgA and Endomysial Antibody are all negative, but the Tissue Transglutaminase is positive.

Is 19.8 "low positive?" Why are the others negative? Is this still possible/probably celiac disease? 

[cyclinglady]

  On 4/3/2018 at 12:51 PM, kg51 said:

32F with a lifetime of various digestive upsets, but nothing that's ever been super severe, and nothing that's been consistent throughout. I had a panel done through my primary care doctor and the results popped up in my online account. While I wait to hear back from her (though I'm a little doubtful of her knowledge and will follow up with a GI regardless)...

Immunoglobin A: 216 (range 70-312)

Gliad (Deanidated) Ab IgG: negative

Gliad Deanidated) Ab IgA: negative

Endomysial Antibody IgA by IF: negative <1:10 (range <1:10)

Tissue Transglutaminase Ab IgA: 19.8 (range <15)

Tissue Transglutaminase IgA Qualitative: positive

So I understand that testing the immunoglobin A is to make sure it's normal to rule out the potential for false negatives. Then IgG and IgA and Endomysial Antibody are all negative, but the Tissue Transglutaminase is positive.

Is 19.8 "low positive?" Why are the others negative? Is this still possible/probably celiac disease? 

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Welcome!  

Yes!  Ask for a Gastroenterologist (GI) referral.  A positive on the TTG that is slightly elevated could be celiac disease or another autoimmune disorder.    The blood test is just the first step in the diagnostic process.  Keep consuming gluten until you see a  GI.  Do not think that a slight elevation or “slightly moderate” equates to no intestinal damage.  

The other tests are negative because they are not all are 100% perfect.      I tested positive to only the DGP IgA and my GI labeled me as slightly positive, yet I had moderate to severe patches of intestinal damage.  

 

[kg51]

Is there a Tissue Transglutaminase range for celiac-positive people? Is my 19.8 considered low?

[kg51]

With a positive Tissue Transglutaminase now, even if a future biopsy were negative, is a gluten-free diet recommended? Goodness, I can't wait to talk to my doctor.

[Before40]

Been through hell myself with all this. I went to so many doctors, specialists, etc. I recently found this place and have actually started getting answers. www.lab600.com I just posted in the forum a few minutes ago. Definetly worth checking out.

[GFinDC]

  On 4/4/2018 at 2:56 PM, Before40 said:

Been through hell myself with all this. I went to so many doctors, specialists, etc. I recently found this place and have actually started getting answers. www.lab600.com I just posted in the forum a few minutes ago. Definetly worth checking out.

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A hair sample can't diagnose celiac disease.  The correct testing includes both blood antibodies and a biopsy via an endoscopy. 

[squirmingitch]

  On 4/3/2018 at 3:33 PM, kg51 said:

Is there a Tissue Transglutaminase range for celiac-positive people? Is my 19.8 considered low?

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It doesn't work that way. Different labs have different reference ranges so one can't judge anything by saying 19.8. That's why we always ask people to list the reference ranges from their paperwork which you did so we didn't have to ask you.

[squirmingitch]

  On 4/3/2018 at 3:38 PM, kg51 said:

With a positive Tissue Transglutaminase now, even if a future biopsy were negative, is a gluten-free diet recommended? Goodness, I can't wait to talk to my doctor.

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The gold standard for diagnosis is positive blood work combined with positive endoscopic biopsy. Why the biopsy? Because the TtG IgA alone could possibly be indicative of some other AI disease going on such as Chron's. Therefore, in your case, it's best to do the endoscopy & find out if anything else is going on in there -- maybe several things are, maybe not but better to know. Right? After that, then you can consider giving the gluten-free diet a good try if the biopsies are negative for celiac. 

I am going to repeat this b/c it bears repeating. This is VERY important!!!!

CONTINUE TO EAT GLUTEN EVERY SINGLE DAY UNTIL THE ENDOSCOPY HAS BEEN DONE.

[cyclinglady]

  On 4/3/2018 at 3:38 PM, kg51 said:

With a positive Tissue Transglutaminase now, even if a future biopsy were negative, is a gluten-free diet recommended? Goodness, I can't wait to talk to my doctor.

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Yes, a gluten free diet could be recommended but only after your GI has completed all testing (including the endoscopy).  Why?  Because your GI could miss damaged areas in the small damage as celiac disease can be patchy.  The small intestine is the size of a tennis court when stretched out.  

Squirmingitches comments are spot on, but I think she missed the range.  Your result was a 19 and the cutoff was 15.  Not a super positive, but it is a positive.  You do not know until you have the endoscopy as celiac antibodies elevations do not always correlate with intestinal damage.   

[kg51]

  On 4/4/2018 at 4:23 PM, squirmingitch said:

It doesn't work that way. Different labs have different reference ranges so one can't judge anything by saying 19.8. That's why we always ask people to list the reference ranges from their paperwork which you did so we didn't have to ask you.

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I posted the range, it's <15 u/ml.

[squirmingitch]

I said you posted the range so we didn't have to ask you. 

Maybe I need to clarify. IF a person came on here & said they tested @ 19.8 & gave no other information then we would have no clue as to whether that was positive or negative. 

OK, maybe you're still asking if the 19.8 is considered low. It's not a matter of it being low as long as it's positive which it is. A positive is a positive is a positive. Don't let a doctor trip you up by saying it's a low positive therefore doesn't mean anything. The only time the actual # means something is if it's off the charts high. Like 100 would be considered off the charts high for a range of <15 or 89 would be off the charts high but normally you don't look at how close to the positive range you tested. If your result was 16, it would STILL be positive & trigger moving to an endoscopic biopsy. 

If I didn't explain that well enough then don't hesitate to ask for clarification.

[kg51]

That was helpful, thank you for your further clarification on your previous comment. I wasn't sure if "a positive is a positive" or not or if a value's closeness to the range mattered.

[squirmingitch]

Good, I'm glad I managed to explain that clearly this time. I knew what I meant before but I certainly didn't make it too clear otherwise -- totally hashed it!