Interpreting First Coeliac Serology Results

[KCG91]

Hi all,
 

I had some bloodwork done and I'm a little confused by the results as I haven't yet seen my GP for him to explain them to me. The tests read like this:

Anti TTG (IgA) Tissue Transgl. 128.000u/mL (0 - 6)

IgA Coeliac 1.510g/L (0.8-3.7)

Am I right in thinking the first test indicates coeliac disease, as what I've found online seems to indicate 10+ u/mL as positive? 128 seems really high in comparison! I have no idea what the second line means. Are the values in brackets the expected/normal/healthy ranges?

What is the possible Anti TTG (IgA) range for someone with coeliac disease - as I said, 128 seems crazy when 10 is a positive result.

So confused, why do all the antibodies etc have to sound so similar?!
Thanks in advance.







 

[GF Lover]

The numbers in brackets are the ranges.  The TTG is positive, If the " IgA coeliac " test is actually the EMA IgA total serum then that is normal showing the TTG could be a false positive.  You really need to review them with your Doctor who can take the blood tests, any symptoms and your history all into consideration. 

 

All the best.

 

Colleen

[KCG91]

Thanks Colleen! I thought the TTG was positive but yeah, it's the IgA that's confusing. Seeing the doc on Friday but just trying to do my homework as it's a locum...

[nvsmom]

I would have guessed the IgA coeliac was the total serum IgA, which is a control test to make sure you make enough IgA for your IgA tests to be accurate - you'd want it right in the middle of the range and it is. I don't remember the units but these look different than what I'm used to. Is this in the UK?

 

The EMA IgA is usually done as a ratio... I forget the correct term. When I had a positive EMA it was written as 1:40 without any units.

 

Anyway, your tTG iGA was very positive. Are you going gluten-free now or are they doing a biopsy on you first?  Either way, welcome to the club and I hope you feel better soon.

[KCG91]

Thanks Nicole! Yes, I'm in the UK which has made understanding the results a bit trickier as most of the information covers the tests done in the US, they seem to be slightly different.
 

I'm having another blood test on Friday - celiac panel maybe? - as my first tests were done at home (England) and I'm now back at university in Scotland and the NHS doesn't share info across the border. When I got my first results back in mid Sept I cut out gluten straight away as I needed all the help I could get for an upcoming marathon (26.2 miles with the runs = not fun). I started eating it again yesterday, so hopefully the two weeks off won't affect the results too much. I'm not keen on the biopsy just yet as it's my final year of uni so I just want to feel better and not mess around with hospitals - I'll probably have it done in a year or so when I have time to feel crap for three months... I just wanted more clarification from the bloods, partly to help 'convince' family and flatmates to take it seriously!

Is there any level of anti TTG IgA where coeliac is pretty much certain and a biopsy might not be so necessary? I read that this was suggested as 100 in kids?

Thank you

[GF Lover]

Because the TTG IgA can also point to other autoimmune diseases, the Doctor will take all tests into account to determine Celiac Disease.  The Doctor can make a differential diagnosis of Celiac and not go forward with the Endoscopy if he believes there are no other issues to consider.  This is completely up to the Doctor. 

 

Good Luck,

 

Colleen

[kareng]

At the ICDS, the doctors were saying that a TTG of over 100 means Celiac.  I guess it doesn't get that high with other diseases.  They still want to biopsy, especially adults or patients they think might have other issues.  They can do a colonoscopy at the same time and rule out a lot of additional problems.  The endoscopy isn't an operation.  It takes, at most,  a day of your life. 

 

Keep eating gluten.  If you were only off for 2 weeks, and your TTG was that high, you should be good.  The doctors at the ICDS did a study about Celiacs eating gluten.  They fed Celiacs who had gotten their TTG back to normal gluten for 2 weeks.  At 2 weeks the TTG wasn't positive but 2 (I think 2, might have been 4) weeks later, after stopping the gluten, it was positive.  It takes a while for us to stop making it.

[nvsmom]

I was going to say something along the same lines. It is usually the weak positives that can be sometimes be caused by things like diabetes, crohn's, colitis, liver disease or thyroiditis. Your result is about 22 times the upper normal limit. It would be pretty safe to say celiac is the cause.

I hope you feel better soon.

[KCG91]

Thanks everyone. My family and friends don't really get it yet so this post has stopped me running off to the only person I know with coeliac disease - my ex boyfriend! Not who you want to discuss your insides with

 

My test on Friday is a full blood count so presumably that will clarify things a bit further. If I still want a biopsy that's a 3-4 month wait... My liver, kidney and thyroid functions have already been checked and I don't have the symptoms for Crohn's or colitis. In fact I have hardly any at all (a tiny bit of bloating and cramps and marginal anaemia) which is good in a practical sense but also scary that my immune system has (probably) been secretly been munching on my intestines!