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Blood Tests And Gluten Challenge


Elsie L

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Elsie L Newbie

Hi. I'm new to the forum, but not new to celiac disease. My daughter, now 46 was born with it. I was told I probably had it (by a physician) but never tested until this yr. First test I had been strictly gluten -free for 2 mos. IGA and IGG were negative. So was the endomesial antibody IGA.

So I did a gluten challenge for three weeks. Tested again. Everything negative but Endomesial antibody went up to just enter the positive range, exactly 1:5.

I'm thinking now I should be on gluten a longer time and test again, because the longer I am on a ciet containing gluten, the more digestive distress I am having.

1. Can anyone explain what the higher endomesial antibody test results might indicate? Should I pursue more testing after a longer gluten challenge?

2. What is an ARA test? Should I have had it or did I already under one of the other names?

3. The nurse read my report to me over the phone, at my request, and mentioned a term that included the words tissue transference (not sure I got it right, but the number she gave me on that was 13, whatever that may mean.

I will meet with my dr. and get these things clear, but frankly I don't think she knows that much about celiac disease or the tests.

I'd like to go armed with the right questions to ask! :)

Thanks for sharing iwhatever nformation you can. Elsie

p.s. I've suffered digestive problems all my life, sometimes called colitis and more recently irritable bowel or "food sensitivities." After being treated for non-hodgkins lymphoma two yrs. ago and learning the higher risk for that among Celiac patients I feel I need to get serious about a definite diagnosis to preserve my present health.


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karen149 Rookie

Here's a great site for explaining all those acrnyms:

Open Original Shared Link

I hope you find an answer soon. It sounds like you would definitely benefit from a gluten-free lifestyle.

Hope this helps!

Karen

Elsie L Newbie

Karen, thanks. I checked the site and obtained some useful information. Elsie

Carriefaith Enthusiast

I think I may be able to help.

I think the test (#3 on your list) is called Tissue transglutamase

Here is a link to a laboratory test information guide for this test:

Open Original Shared Link

If this was the test you had and you had a reading of 13 than I think it means you MAY have tested positive for celiac (I'm not a doctor!). It says on the website that a normal reading is less than 10 U/ml. But it also says "Tissue Transglutamase may give persistent mildly elevated results in the absence of disease". Definitely worth looking into! Of coarse check this info with your doctor.

Tissue transglutamase is the blood test that I had and I was told that this blood test is vey specific for celiac disease.

gf4life Enthusiast

Different labs use a different reference range. For the Tissue Transglutaminase test most labs say under 20 is negative, a few use under 10 as negative. It is the most specific bloodtest for Celiac.

ARA is Anti-Reticulin Antibody. It is as far as I can tell an outdated bloodtest that very few doctors or labs rely on anymore for Celiac testing. It is still included in some celiac panels though. On mine it said I was negative for the screening test for it, so the actual test was never performed.

The fact that your IgA endomysial antibody went up when you went back on gluten is an indication that gluten may be causing your symptoms, but if you want a definative diagnosis you would have to go back on gluten for anywhere from 3-6 months or more to get more accurate test results. Otherwise you could just continue on the gluten free diet and see if it helps. I went back on gluten for two months and it was not long enough to show my doctor the damage she wanted to see to give the diagnosis of Celiac. I opted for Enterolab testing to get my answers. I am very happy with their testing methods and it is certainly an option. You can check them out at Open Original Shared Link

God bless,

Mariann

tarnalberry Community Regular

ARA can - as far as I've been able to discover - indicate either autoimmune kidney problems as well, but usually celiac. It's actually relatively specific (in theory), but not very sensitive. (Plenty of celiacs won't have it raised.) That, actually, was my only positive test. (I couldn't get any values on the rest, so I don't know if they were borderline.) When I combined that with a positive result when going on the diet - and doing a dietary challenge - I took that as my answer. It is an indirect test though, and definitely not too many doctors run it any more.

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    • trents
      NCGS does not cause damage to the small bowel villi so, if indeed you were not skimping on gluten when you had the antibody blood testing done, it is likely you have celiac disease.
    • Scott Adams
      I will assume you did the gluten challenge properly and were eating a lot of gluten daily for 6-8 weeks before your test, but if not, that could be the issue. You can still have celiac disease with negative blood test results, although it's not as common:  Clinical and genetic profile of patients with seronegative coeliac disease: the natural history and response to gluten-free diet: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5606118/  Seronegative Celiac Disease - A Challenging Case: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9441776/  Enteropathies with villous atrophy but negative coeliac serology in adults: current issues: https://pubmed.ncbi.nlm.nih.gov/34764141/  Approximately 10x more people have non-celiac gluten sensitivity than have celiac disease, but there isn’t yet a test for NCGS. If your symptoms go away on a gluten-free diet it would likely signal NCGS.
    • Xravith
      I'm very confused... My blood test came out negative, I checked all antibodies. I suppose my Total IgA levels are normal (132 mg/dl), so the test should be reliable. Still, I'm not relieved as I can't tolerate even a single biscuit. I need to talk to my doctor about whether a duodenal biopsy is necessary. But it is really possible to have intestinal damage despite having a seronegative results? I have really strong symptoms, and I don't want to keep skipping university lectures or being bedridden at home.
    • Scott Adams
      They may want to also eliminate other possible causes for your symptoms/issues and are doing additional tests.  Here is info about blood tests for celiac disease--if positive an endoscopy where biopsies of your intestinal villi are taken to confirm is the typical follow up.    
    • Scott Adams
      In the Europe the new protocol for making a celiac disease diagnosis in children is if their tTg-IgA (tissue transglutaminase IgA) levels are 10 times or above the positive level for celiac disease--and you are above that level. 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: Blood Test Alone Can Diagnose Celiac Disease in Most Children and Adults TGA-IgA at or Above Five Times Normal Limit in Kids Indicates Celiac Disease in Nearly All Cases No More Biopsies to Diagnose Celiac Disease in Children! May I ask why you've had so many past tTg-IgA tests done, and many of them seem to have been done 3 times during short time intervals?    
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