Help With Blood Work

[mommarazzi2]

Hello,

Last week we had our 2 year old sons blood tested for a bunch of allergies.  His symptoms have been ongoing and never changing diarrhea since birth.  At every new stage of new milk or formula Dr would say oh its just the change it will get better. Well it never did and so I brought him to a Pediatric GI.  He also has an unexplained eczema that he has had also since he was a newborn.  The test results are negative for Celiac but I would like your opinion.......also he was negative for the long list of food allergies that they tested for.

 

Here are his results.

IgA 58. Range is 11-134

IgA1 53. Range is 7-132

IgA2 6. Range is 1-23

 

IgE is 28. Range <61.

 

tTG Negative

tTG antibody IgA was 3.10. Range is <20.

 

Thank you everyone for your help.  I know that he can test negative and then we have an endoscopy done and they find that he does indeed have Celiac.  

 

[nvsmom]

IgE looks normal so it doesn't look like an allergy (as far as I know).

 

I'm not sure what the three types of IgA testing were for. I've never seen that done. He does appear to make adequate levels of IgA though so his tTG IgA should be fairly accurate... as accurate as it can be in toddler.  His tTG IgA is negative but those tests do tend to miss celiacs who are toddlers more often than adults.  The tTG IgA is 75-95% sensitive so there is a 5-25% chance his test is a false negative - probaby closer to the lower end because his IgA levels are adequate. This report discusses it on page 10-12: Open Original Shared Link

 

As you pointed out, he could still have celiac disease in spite of the negative test. Are the other tests available to him? This is the full panel:

tTG IgA and tTG IgG

DGP iGA and DGP IgG (best test for children)

EMA IgA (detects more advanced cases)

AGA IgA and AGA IgG (older and less reliable test thought by some to also show non-celiac gluten intolerance - NCGI)

 

The DGP test might show you something, or even the IgG based tests...

 

There is also the chance that he has NCGI in which case he will have all the same horrible symptoms of celiac disease but not the villi damage (the blood tests look for autoantibodies that cause the villi damage). All you can really do is go gluten-free to test that theory- once all other testing is done.

 

My boys all had negative tTG igA tests, which were the only tests available to us, but I am a celiac and 2/3 of my kids had symptoms so I made them all gluten-free, and they are all much healthier because of it. You may have to go gluten-free without a doctors order; if you do, give the gluten-free diet at least 3 months before you judge it's effectiveness as healing takes time.

 

Good luck in what ever you decide to do.

[powerofpositivethinking]

just copying and pasting what I wrote in your other post

 

this link helped me learn about the different types of blood immunoglobulins when I first started researching: Open Original Shared Link

 

the following tests are not diagnostic of celiac, but instead tell you that your son makes normal levels of IgA and IgE.

 

Here are his results.
IgA 58. Range is 11-134
IgA1 53. Range is 7-132
IgA2 6. Range is 1-23

IgE is 28. Range <61.

 

The only celiac test that was completed was:

 

tTG Negative
tTG antibody IgA was 3.10. Range is <20.

 

Even though your son produces a normal amount of IgA and his TTG is negative, he really should have the DGP IgA and IgG based tests performed because they can be more helpful in finding celiac diesease in young children. 

 

take a look at the last line in this link: Open Original Shared Link

 

take a look at this abstract as well regarding DGP to young children:  Open Original Shared Link

 

I'd say before moving onto the endoscopy, see if you can get the doctor to run the deamidated gliadin peptide IgA and IgG versions. 

 

good luck!

[powerofpositivethinking]

I agree, Nicole.  I did some searching, and here was the best explanation I could find:

 

IgA Subclasses IgA1

IgA1 comprises approximately 85% of total IgA concentration in serum. Although IgA1 shows a broad resistance against several proteases, there are some that can affect / splice on the hinge region. IgA1 shows a good immune response to protein antigens and, to a lesser degree, to polysaccharide and lipopolysaccharides.

IgA2

IgA2, representing only up to 15% of total IgA in serum, plays a crucial role in the mucosa of the airways, eyes, and the gastrointestinal tract to fight against polysaccharide and lipopolysaccaride antigens. It also shows good resistance to proteolysis and many bacterial proteases, supporting the importance of IgA2 in fighting bacterial infections.

 

 

I'm not sure what the three types of IgA testing were for. I've never seen that done.

 

[mommarazzi2]

Awesome! Thank you all so much! I will bring it up to the dr that I don't believe the full blood panel was done.

I was confused for sure and thought the iGA1 was apart of celiac panel.

[nvsmom]

Awesome! Thank you all so much! I will bring it up to the dr that I don't believe the full blood panel was done.

I was confused for sure and thought the iGA1 was apart of celiac panel.

 

The total serum IgA is run because about 5% of celiacs are deficient in IgA (which is higher than the regular population) which means that any IgA based testing (tTG IgA, DGP IgA, EMA IgA) that is done will most likely yield a false negative result if the patient is in fact a celiac. Those low in IgA will need to rely on IgG based tests instead. I think it's a good idea to run those anyway as there are a few celiacs around here who were diagnosed with only positive IgG based tests.