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Help With Results Pls


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4 replies to this topic

#1 Guest_christyworthington_*

 
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Posted 25 June 2004 - 06:21 PM

Hi all,
I recently had blood work done on my 2 children. My Daughters came back as follows
GLIADIN AB IgG 67 (moderate to strong positive)

GLIADIN AB IgA 7 (negative)

ENDOMYSIAL IgA AB 3 (negative)

Could somebody please help me interpret these results and advise me of any other tests that may or may not be needed to determine if she is celiac or not.
I have discussed this with the Doctor but would like to hear some opinions if possible.
Many thanks in advance
Chris
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#2 celiac3270

 
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Posted 26 June 2004 - 03:17 AM

Okay...there's some stuff on Celiac.com on interpreting stuff, but I couldn't get through it, so I found another site...........which I also can't get through.... :) ....they make this stuff hard to understand: :)

1. Serological
a. The blood tests recently developed for the detection and screening of celiacs and their relatives are a useful aid to diagnosis and monitoring. The tests have a clinical utility in:


Screening at-risk populations to identify biopsy candidates
Providing information to support a diagnosis of celiac disease
Monitoring adherence to a gluten-free diet
b. There are two classes of antibodies seen in untreated celiac disease: Antibodies directed against a fragment of gluten called gliadin and antibodies directed against some tissue in the body itself, endomysial (the covering of muscle), and reticulin (the framework for kidney and liver). There are other types of antibodies to the body's own tissues.
The actual tests are done using blood from the patient. The blood cells are removed. The gliadin test is usually an automated machine read test. While this means there is little room for interpreter error, there are no standardized tests, normal ranges, or even standardized methods in use in the US.

The endomysial tests are more dependent on the experience and ability of a pathologist in looking at a pattern of staining produced by the patient's serum on a slice of monkey esophagus or human umbillical cord. While this test is done in a similar way in most labs there are differences in how these are interpreted.

c. How good are these tests?

If all of the tests are positive then they are pretty accurate, GT 95% right. However, there are several reasons and circumstances when they are not so accurate. IgA and IgG are two different varieties of antibodies we have in our immune systems. The IgA gliadin and IgA endomysial tests are the most accurate and also become negative relatively quickly after stopping gluten (3-6 months). The IgG is not as specific (it can be positive in non celiacs). However it is important to do both, as about 4% of celiacs have low enough levels of IgA to make the IgA tests inaccurate.

These tests can only be given to a patient that is consuming gluten. The amount and time require for a gluten challenge varies and is a factor for consideration when scheduling the test.

Negative results do not indicate that the patient will never develop Celiac Disease, only that it is not currently a factor. HLA typing can be used to determine if a person has the genetic factors that are associated with celiac disease; without these genetic factors celiac disease is very unlikely to ever develop. For more information, access the file CELIAC CEL-HLA with the GET command from listserv@maelstrom.stjohns.edu.

Needless to say the interpretation of mixed results (i.e. some positive and some negative) is complicated. Also the interpretation and use of these tests in infants may be different, due to lower levels of IgA.


Okay, then there was a table I found in the FAQs of this site, which tells you how important each of the tests are for telling you "yes" or "no" with celiac disease:

Each of these three tests provide a certain degree of reliability for diagnosing celiac disease. Of these, endomysial antibody is the most specific test. The following table is taken from our studies (Lerner, Kumar, Iancu, Immunological diagnosis of childhood coeliac disease: comparison between antigliadin, antireticulin and antiendomysial antibodies).

     % Sensitivity     % Specificity     Predictive Value
                                            % Pos.     % Neg.
EMA        97                98            97         98
ARA        65               100           100         72
AGA
  IgG      88                92            88         92
  IgA      52                94            87         74



I'm not a doctor, so I can't interpret all this, but with the information, I think we could all take a stab at trying to interpret it.... :) ....probably, you'd be best off with a biopsy, either way, since some Celiacs can come out negative on the blood, positive on the biopsy......there is some Enterolab gene test....a gene test would be good to get you suspicious (if your daughters have it) and then, I guess, a biopsy would confirm it. As for the results....maybe there's someone on the board who is good with this stuff....to me it looks slightly borderline, but perhaps slightly negative.....just based upon the percentages of Pos./Neg.....don't take my word on it, though.......like I said.....I'm not a doctor and this is just my guessing. Shouldn't a doctor interpret this for you?

-celiac3270
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#3 gf4life

 
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Posted 26 June 2004 - 05:46 PM

Most doctors would say the results are negative and not test further, others are willing to do the biopsy just to be sure. All three of my kids tested similar to your daughter. All had positive IGG only, negative on everything else. While waiting for the follow-up appointment (two months later) I had the kids tested through Enterolab. All three tested positive on Gliadin IgA and tTg stool tests and have genes that cause either Celiac or gluten intolerance. With this information and the improvement on the diet the doctor and I agreed not to do a biopsy on any of them. This means that they are getting healthy, but do not have an official diagnosis.

I personally tested negative on all the blood tests including the biopsy, yet positive on the stool tests. I was not too surprised at the negative test results given that I had previously been on a gluten free diet and being gluten free before testing can mess things up for future testing. I feel so much better off gluten and was getting sicker everyday on gluten. So I know that is my problem.

As for whether you should ask fo rmore testing, that is a decision you have to make, but from my personal experience even a positive IGG blood test suggests further testing would be a good idea.

Do you mind me asking what your daughters symptoms are, and how you came about getting them tested? Do other family members have it? Just curious.

God bless,
Mariann
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~West Coast-Central California~

Mariann, gluten intolerant and mother of 3 gluten intolerant children

#4 GEF

 
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Posted 27 June 2004 - 06:07 PM

Hello Chris.

I'm sure it will be of some comfort to know that you're not the only one who's wondering about what your results mean. I too am IGG positive only. I had an endoscopy and it was normal, so at least I know I'm not celiac. It still doesn't rule out gluten intolerance though. I'm still in the process of getting tests done with my doctor, but from what I've heard is that if you're IGG is positive, it might not be celiac, it could be something else causing that anti-gliadin to show up. There are many, many people that will tell you that it took a while for the other anti-gliadins to show up in their blood, or even for an endoscopy to show any signs of damage to the intestine. I know how you're feeling, believe me... keep searching, keep asking until you get your answers. My family is pre-disposed to auto-immune disease (lupus)... if you have anything of the sort in your family, see if your doctor can run an ANA. If I test positive, I'll probably have to go gluten-free anyway... I just really would like to know where the root of the problem is. Anyhow, keep searching, keep asking questions and I hope you'll get some answers and feel better soon.

Gretchen
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#5 Guest_christyworthington_*

 
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Posted 29 June 2004 - 03:16 PM

Do you mind me asking what your daughters symptoms are, and how you came about getting them tested?  Do other family members have it?  Just curious.

God bless,
Mariann

Thankyou for your replies.

My daughter does not really present any symptoms continuously. She has in the past suffered nausea and diarrohrea *sp. The test are more for peace of mind really.
I hadn't really noted how serious the disease was until i found this site. Growing up all my mum told me was, not to eat flour it will make you ill.
Thanks again
Chris
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