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Test Results


MissKris2

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MissKris2 Newbie

Hi everyone! I had some labs done recently and. First, I should say that I was almost entirely gluten-free for 2 months recently. I started eating gluten again so that I could possibly get a diagnosis. I had been eating gluten for about 3 weeks prior to the labs being done.

Deadimated Gliadin Abs, IgA 4 (0-19)

Deadimated Gliadin Abs, IgG 2 (0-19)

t-Transglutaminase IgA <2 (0-3)

t-Transglutaminase IgG 21 (>9 is strong positive)

So, the only thing I tested positive for was the tTG IgG.

My doctors don't seem to know much about gluten intolerance. I have a biopsy in about a month. Just wondering if anyone had any thoughts on the test results. Thanks!


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JoshB Apprentice

Transglutaminase IgG is concidered a little less reliable than ttG IgA, but everything I read says it is still very reliable, and you seem to have a strong positive. If it were me I would forgo the biopsy unless I needed it for insurance reasons or your own peace of mind. You already have a positive reading for a test which is more accurate than the biopsy. The biopsy might help you figure out how much damage you've already got, however.

It's a little strange that your ttg-IgA would be so relatively low. It's possible to have some general immune system deficiencies that can influence that. This is usually tested for in a celiac panel, but didn't seem to be in your case.

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MissKris2 Newbie

Thanks for replying! The panel did also include Endomysial Antibody IgA (negative) and Immunoglobin A, Qn, Serum which was 126 (70-400=normal). Sorry, I guess I should have included that info. It's frustrating when it seems like the doctors don't know any more about it than I do (and sometimes less!).

JoshB Apprentice

They generally don't know as much, and as easy as it is to get angry about that, it's not really their fault. It's a very hard disease to catch, and a fairly small number of people have it. How much would you learn if you were a doctor and had two patients with a particular disease that they saw another specialist about anyway. If it even looks like you might have it you've probably gone and read 10X more on the subject than your doctor has ever come across. And remember what your GP doctor has seen is half remembered and thirty years out of date from med-school.

MissKris2 Newbie

I know. I'm not angry, just frustrated. Especially when the doctors think I'm a hypochondriac and that all of my symptoms are from "stress." Anyway, thanks again for replying!

MissKris2 Newbie

I guess I'm wondering if the positive tTG IgG is irrelevant if I'm not IgA deficient.

pain*in*my*gut Apprentice

I guess I'm wondering if the positive tTG IgG is irrelevant if I'm not IgA deficient.

No, it's not irrelevant. It is entirely possible that you do have something going on, and I would go ahead with the biopsy, especially if you are symptomatic.

Immunology is a very tricky science, and it is wrought with inconsistencies and the unexplained. I used to work in the field (I'm a med tech), and sometimes it's impossible to get a perfect picture of what a disease "should" look like on paper.

It makes me angry (yes, angry) when doctors disregard patients because they don't fit the "typical" picture. I understand that they are taught in med school that "if you hear hoof beats, look for horses, not zebras". But if the patient has proven themselves to not be a horse, it's time to see if they might be a zebra!! :angry:

I could go on, but I won't. I ate to much gluten today (stupid gluten challenge) that I feel like I am going to barf.


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JoshB Apprentice

I know. I'm not angry, just frustrated. Especially when the doctors think I'm a hypochondriac and that all of my symptoms are from "stress." Anyway, thanks again for replying!

Heh. My stomach troubles were "stress" from when I was six.

MissKris2 Newbie

Thanks for your reply, pain*in*my*gut! I know what you mean about doctors discounting you because you're not the "typical" celiac. Luckily the nurse practitioner at my GI office is more open-minded because she has family who had atypical symptoms of celiac disease, but even she isn't extremely knowledgeable on the subject. I guess we'll see what happens with the biopsy :rolleyes:.

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    • knitty kitty
      Welcome to the forum, @Kiwifruit, I agree further testing is needed.  Disaccharidase deficiency is a symptom of Celiac disease.   On your test results, this line  "IgA: 0.9 g/l (norm 0.8 - 4.0)" is referring to Total IgA and it's very low.  People with low or deficient Total IgA should also have DGP IgG test done.  Low Total IgA means you are making low levels of tTg  IgA as well, leading to false negatives or "weak positives".  Maybe a DNA test for known Celiac genes.   Anemia, diabetes, and thiamine deficiency can cause test results like these.  Get checked for B12 deficiency anemia and have your iron (ferritin) checked.  Vitamin D deficiency is common, too.   Might be time to find a gastrointestinal doctor who is more familiar with diagnosing Celiac Disease.   Best wishes on your journey!  Please keep us posted on your progress.  
    • trents
      Yes, there is a trend in the medical community to forego the endoscopy/biopsy and grant an official celiac diagnosis based on high tTG-IGA antibody scores alone. This trend started in the UK and is spreading to the USA medical community. And yes, 5-10x the normal level is what I have been seeing as the threshold as well. Here is the relevant section dealing from the article above dealing with the importance of the total IGA test being ordered. See the embedded attachment.
    • hmkr
      Ok, interesting. Not what I was thinking that meant. I'm reading the article and trying to understand. I see this “According to the latest research, if the blood test results are at certain high levels that range between 5-10 times the reference range for a positive celiac disease diagnosis, it may not be necessary to confirm the results using an endoscopy/biopsy” My IgG is 90, which is 6 times. So to me that means it's highly likely I do have it. 
    • trents
      It just means you aren't IGA deficient, i.e., that IGA deficiency cannot have given you artificially low scores in the individual IGA celiac antibody tests. This is explained in the article Scott linked above.
    • hmkr
      Normal range: 70 - 400 mg/dL, a little above middle of the range. So what does that mean? Thank you! I will check out that page you linked. Appreciate it! 
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