Help Understanding Blood Panel Results

[Sulbin]

Thank you in advance for any help understanding my son's celiac disease blood panel.  He is 2 years, 3 months and has stomach issues since birth.  I have not been formally diagnosed myself, but went gluten free to become pregnant (after 3 years of unexplained infertility), and have stomach issues and what I suspect is DH when if I eat gluten.

 

I've googled, read, re-read how to read the results, but I just can't seem to figure it out.  We will be scheduling him to see a GI (as suggested by the asthma/allergist specialiast per these results).  While we wait, I'm hoping somebody can break these results down for me:

 

Serological evidence for celiac disease is present.  Consider IgA deficiency.

 

Tissue Transglutaminase AB, AGA <1 U/ML

<4 No antibody detected.... > or = 4 Antibody detected

 

Immunoglobulin A 21 mg/dl

24-121 is the range given with that result

 

Gliadin (deamidated) AB (IGA) 1 U

reference ranges for Gliadin (Deamidated peptide) Antibody (IGA) < 20 U Antibody not detected >=20 antibody detected

 

Immunoglobulin E 29 kU/L

<or = 93 was written after that

 

Tissue Transglutaminase AB, IGG 7 U/ml

Range given <3 No antibody detected, > or = 6 Antibody detected

[nvsmom]

Welcome to the board.

 

About 5% of celiacs are deficient in immunoglobulin A (IgA) which is the part of the immune system that deals with the mucosal linings such as in the nose, mouth, and intestinal tract. It's not something that will have a large impact on someone's health, except maybe an immune "under-reaction" when an infection is in those areas.

 

What an IgA deficiency means to a celiac is that the celiac tests that are based on the the IgA part of the immune system (tTG IgA, DGP, IgA, and EMA IgA) will not be accurate (possibly give a false negative) because there won't be enough autoantibodies to register on the tests. Those who are low in IgA will need to rely on the IgG based tests or the endoscopic biopsy.

 

It looks like your son's tTG IgG test was positive. That's a pretty specific test to celiac disease. Chances are he'll need to be gluten-free once all testing (biopsy if warranted) is done.   If you want more blood tests for him, you could always request the EMA IgG and the DGP IgG tests.

 

This report has more info on the tests starting on page 10:

Open Original Shared Link

[Sulbin]

Thank you for your welcome, and thank you for your response as well!

 

I'm going to throw out a clarifying statement.  Please let me know if I understand or not:  His results show he has an IGA deficit.  Because of this, his testing may not be acurate.  However, his Tissue Transglutaminase AB, IGG shows antibodies, so that trumps the other tests, and means highly probable chance of celiac disease?

 

I just want to be informed before going to the GI.  My own curisoity, but also because I want to make an informed choice when we are there.  I want the least invasive testing for the most relable results.  (Don't we all, but especially for a 2 year old.)

 

And... don't give a frown face for having to go gluten free.  We were already 95% gluten-free anyway.  I make a mean pancake and lemon loaf  .  I'm hoping that totally gluten free will heal him up enought to have cheese someday.  A momma can dream!

[nvsmom]

 

I'm going to throw out a clarifying statement.  Please let me know if I understand or not:  His results show he has an IGA deficit.  Because of this, his testing may not be acurate.  However, his Tissue Transglutaminase AB, IGG shows antibodies, so that trumps the other tests, and means highly probable chance of celiac disease?

 

That is completely correct. There are a few parts to the immune system that the immunoglobulins measure (IgA, IgE, IgG, IgM), and celiac disease is testable is two parts: IgA and IgG. Many people are positive in the IgG version of the tests even when they don't have an IgA deficiency.

 

Below is the full panel of celiac tests that can be run; as you can see almost half are IgG based - it's a very valid and accurate way to test.

 

tTG IgA and tTG iGG

DGP IgA and DGP IgG

EMA IgA

total serum IgA (the control test to look for IgA deficiency)

AGA IgA and AGA IgG (older and less reliable test)

 

And about the cheese, it took me a year but I got cheese back.  

[Sulbin]

And about the cheese, it took me a year but I got cheese back.  

 So there is hope!

 

Thank you for your responses.  Very helpful.

[frieze]

if he has been that close to gluten free for any length of time, it could be a false neg. on the IgA testing, since he is very narrowly under.