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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
      Take it easy! I was just prompting you for some clarification.  In the distillation process, the liquid is boiled and the vapor descends up a tube and condenses into another container as it cools. What people are saying is that the gluten molecules are too large and heavy to travel up with the vapor and so get left behind in the original liquid solution. Therefore, the condensate should be free of gluten, no matter if there was gluten in the original solution. The explanation contained in the second sentence I quoted from your post would not seem to square with the physics of the distillation process. Unless, that is, I misunderstood what you were trying to explain.
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      No they do not contradict each other. Just like frying oil can be cross contaminated even though the oil doesn't contain the luten protein. The same is the same for a distilled vinegar or spirit which originally came from a gluten source. Just because you don't understand, doesn't mean you can tell me that my sentences contradict each other. Do you have a PhD in biochemistry or friends that do and access to a lab?  If not, saying you don't understand is one thing anything else can be dangerous to others. 
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      @Mynx, you say, "The reason this is believed is because the gluten protein molecule is too big to pass through the distillation process. Unfortunately, the liquid ie vinegar is cross contaminated because the gluten protein had been in the liquid prior to distillation process." I guess I misunderstand what you are trying to say but the statements in those two sentences seem to contradict one another.
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      It isn't a conjecture. I have gotten glitened from having some distilled white vinegar as a test. When I talked to some of my scientists friends, they confirmed that for a mall percentage of people, distilled white vinegar is a problem. The cross contamination isn't from wheat glue in a cask. While yhe gluten protein is too large to pass through the distillation process, after the distillation process, the vinegar is still cross contaminated. Please don't dismiss or disregard the small group of people who are 100^ gluten intolerant by saying things are conjecture. Just because you haven't done thr research or aren't as sensitive to gluten doesn't mean that everyone is like you. 
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