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Endomysial Vs. Transglutaminase Test


Dcoughli

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Dcoughli Newbie

Hi - this is my first time writing but I am at wits end in finding an answer. My daughter has been on "watch" for Celiac for 2 years. She is 8 years old and two years ago starting having stomach aches around dinner, she is often in the bathroom, stools are somewhat normal. Her Endomysial test is normal but the Transglut tests was 97 2 years ago, 44 last year and now is 89, all well above normal range. She had a scope 2 years ago that was normal. I am concerned given the non-treatment of this disease that we are waiting for a positive biospsy. She has since had an Impedance Probe test (last week) because she has so much gas in her she feels like she is going to vomit, so we are checking for reflux.

I have an appt on Tues to go over the lab and probe results and most likely will have another scope procedure for biopsies. What questions should I be asking? We took the new genetic test to rule her out and could not. She has not changed clothing size for over a year, he is 52 inches and 59 lbs.

Any guidance or comments are appreciated.


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Emme999 Enthusiast

Here's a little info on the tests:

The tTG is extremely sensitive. This is from the book "Dangerous Grains" (my fav. book to quote )

"The tTG test usually identifies about 98% of those who have celiac disease, and it is a very specific test that can be used to rule out celiac disease in 95% of patients. This test appears to be superior to endomysium antibody testing, not only because it is less costly but also because it is a little better at identifying celiac disease and because interpretive bias is reduced by the use of computer scanning."

As for EMA Testing:

"This test is very sensitive, and it will identify 90% or more of those patients with flat intestinal walls, but some evidence suggests that it is less reliable for identifying cases with milder intestinal damage. ... However, a negative EMA blood test has limited value for excluding celiac disease. This test is also limited by the need for individual observation and evaluation of stained blood cells."

I hope that helps :)

Good luck!

- Michelle

Guest jhmom

Hi and welcome to the board! I am sorry to hear your daughter is sick, I know it's hard to deal with when our children are not well no matter how old they are ;)

My daughter is 9 (almost 10) and has had problems pretty much since day one. I started getting sick in 2002 and after going the "traditional doctor" route and getting nowhere because all my tests/procedures came back normal I decided to get tested through Enterolab. When my test came back positive I decided to have my daughter tested too. I didn't want to put her through all the tests I went through, her test came back positive too. After going gluten-free she was like a new child, she didn't complain after eating, she wasn't grumpy all the time and seemed to have more energy.

My suggestion to you is, since your daughter's blood tests are positive I would put her on a gluten-free diet. I know some people swear by biopsies but I personally do not think they are necessary if labs are positive or if you improve on a gluten-free diet.

I wish you luck and hope your daughter feels better soon! :)

Lesliean Apprentice

When a blood test, especially EMA or tTG comes back positive I think you can conclude the diagnosis is positive for Celiac disease. The biopsy is no longer always recommended as some doctors think it is like waiting for the heart attack to verify the EKG test that measured heart irregularities. The tTG test already shows a reaction to gluten.

Here is a website to look at: Open Original Shared Link

Here is another concerning biopsy reliability.

https://www.celiac.com/st_prod.html?p_prodid=25

Good luck and best wishes for your daughter's good health.

Leslie

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    • trents
      I would ask for a total IGA test (aka, Immunoglobulin A (IgA) and other names as well) to check for IGA deficiency. That test should always be ordered along with the TTG IGA. If someone is IGA deficient, their individual celiac IGA test scores will be artificially low which can result in false negatives. Make sure you are eating generous amounts of gluten leading up to any testing or diagnostic procedure for celiac disease to ensure validity of the results. 10g of gluten daily for a period of at least 2 weeks is what current guidelines are recommending. That's the amount of gluten found in about 4-6 slices of wheat bread.
    • jlp1999
      There was not a total IGA test done, those were the only two ordered. I would say I was consuming a normal amount of gluten, I am not a huge bread or baked goods eater
    • trents
      Were you consuming generous amounts of gluten in the weeks leading up to the blood draw for the antibody testing? And was there a Total IGA test done to test for IGA deficiency?
    • jlp1999
      Thank you for the reply. It was the TTG IGA that was within normal limits
    • trents
      Welcome to the forum, @jlp1999! Which IGA test do you refer to as being normal? TTG-IGA? Total IGA? DGP-IGA? Yes, any positive on an IGA or an IGG test can be due to something other than celiac disease and this is especially true of weak positives. Villous atrophy can also be cause by other things besides celiac disease such as some medications, parasitic infections and even some foods (especially dairy from an intolerance to the dairy protein casein). But the likelihood of that being the case is much less than it being caused by celiac disease.
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