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Blood Tests And Gluten Challenge
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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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Here's a great site for explaining all those acrnyms:

http://labtestsonline.net/

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

Hope this helps!

Karen

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

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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:

http://www.lhsc.on.ca/cgibin/view_labtest....mase%20antibody

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.

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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 http://www.enterolab.com

God bless,

Mariann

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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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    • Thanks Stephanie & Gemini for the info. that the 4 of 5 doesn't apply to children. I wasn't aware of that until now. 
    • I think the posters above have given you very good information and I will throw in my 2 cents worth.  I am surprised that they did not test her DGP IgA also.  I am sure that would have been positive.  They switched off with antibody classes and usually they do both tests for both antibodies.  IgA is more specific to Celiac but the IgG is also useful.  The testing shows your daughter is producing antibodies to the gluten in her diet. (DGP IGG). THe tTg shows positive for some damage or inflammation. You know........your daughter is only 4.  She hasn't been on the planet or eating gluten that long. It can take years for enough damage to occur for it to be able to be found on biopsy.  I would say it is highly likely that this is Celiac, especially with her symptoms. But because the damage hasn't graduated to bad enough yet, they won't diagnose her. I think you need to do what others have said and get all copies of testing and find someone else who will take a look and give a diagnosis, especially if they have you do a dietary trial and her symptoms go away.  That might be the only recourse if you want faster proof. I know I would want faster.  I would not really be happy if I thought I had to keep feeding her something that was making her sick.  If you keep her on gluten long enough, the diarrhea will probably show up. BTW.........the criteria mentioned regarding diagnosis does not apply to kids.  I know it's silly and stupid but most leading Celiac specialists do not go by this criteria for kids.......adults only.  Keep that in mind because it might come up.  You could recognize it but they might not. Have you considered gene testing, to help bolster a diagnosis? As far as false positives go, it's the other way around. False negatives happen more frequently than many people think.  It's a recurring theme here.  With her symptoms, which is what I had, a bloated belly and tummy aches are telling.  Have they tested her for lactose intolerance?  That can cause similar symptoms, although it sure won't raise those 2 blood tests.  Keep looking for Celiac because there are many red flags here.
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