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Test Results --- Thoughts?
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I know there are a lot of posts like this and so I am sorry that I am creating another one. Any help would be greatly appreciated.

My Rheumatologist decided to test me for celiac disease based on some symptoms when I saw her for consistently high C-reactive protein and ESR levels. I have yet to hear back from her regarding these results, as she is on vacation, but I asked the office to fax my blood test results.

Any thoughts and feedback on these results would be very helpful.

Test Name. Results. Reference Range

IGA, serum. 330 mg/dl. 81-463 mg/dl. normal

IGG, serum. 1686 mg/dl. 694-1618 mg/dl. high

IGM, serum. 133 mg/dl. 38-271 mg/dl. normal

Gliadin AB IGA. 77 U. < 20 U. high

Gliadin AB IGG. 2 U. < 20 U. normal

tTG AB IGG. 2 U/mL. < 6 U/mL negative

tTG AB IGA. < 1 U/mL. < 4 U/mL. negative

unrelated abnormal results:

C-Reactive Protein. 2.6 mg/dl. < 0.8 mg/dl. high

ESR, Westergren. 40 mm/hr. 0-20 mm/hr. high

Is it possible with these results to say I have celiac disease or will I need a biopsy to get a conclusive diagnosis? I am also seeing a Rheumatologist for another, yet to be diagnosed, autoimmune disease causing the high CRP and ESR bloodwork.

Thanks in advance!

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Welcome to the board, Melissa. :)

 

Your serum immunoglobulin tests (IgA, IgG, IgM) are not actually celiac tests. They tend to run those to get a better idea of what various parts of your immune system is doing (as I understand it).  Celiac mostly involves the IgA which is the mucosal linings in the the body. The IgA can be a bit elevated in celiacs but they usually run the IgA test to look for a deficiency (5% of celiacs are low in IgA) which will affect the celiac test results.

 

The tests (anti-gliadin antibodies or AGA IgA and AGA IgG)  your rheumy ran are older tests and not the most reliable. They show a sensitivity to gliadin and are thought by some to indicate either celiac disease or non-celiac gluten intolerance (NCGI) but with a history of autoimmune disease (is it RA?) then it is probablypositive for celiac disease.

 

The other tests are: 

tTG IgA and tTG IgG (most common celiac test)

DGP IgA and DGP IgG (newer test - good for earlier detection)

EMA IgA (positive in advanced cases)

 

This report goes through the tests in greater detail on pages 10-12:  http://www.worldgastroenterology.org/assets/export/userfiles/2012_Celiac%20Disease_long_FINAL.pdf

 

You might want to do more testing before going off of gluten. You will need to continue eating gluten for the biopsy too, should you or the doctor feel that is something you should do. Not all doctors require the biopsy for a diagnosis now a days which I think is a good thing because they sometimes miss the damage when they are in there - the intestinal surface area is that of a tennis court so there is lots to miss.

 

I personally chose to skip the biopsy based on a couple of positive tests and my symptoms. I have never regretted skipping it but I was satisfied with the positive celiac tests I had and have had no problem staying gluten-free.

 

Best wishes. I hope others help you out with more info.

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