Only Igg Positive In A 5 Year Old

[alcie]

My 5 year old daughter had a blood test for celiac by her pediatric GI due to cronic constipation and heart burn.  Both her IGA and TTG are normal but her total IGA was below normal and her IGG came back as a strong positive.  Her doctor gave us a couple of choices, 1) we can get an endoscope to look for damage from celiac and if there is none he's fine waiting 2 years for another blood test, or 2) we can wait and get another blood test every 6 months or so.  He did recomend trying a dairy free diet while we decided what path to take for the celiac testing.  Can anyone tell me what the numbers below might mean for someone this young?

 

Anti-Giladin IGG: 33 strong positive (20-30 is a weak positive, 31+ is a strong positive)

Anti-Giladin IGA: 1 negative (normal is 0-19)

TTG IGA: less than 2 (negative is 0-3)

Total IGA: 42 (normal is 44-89)

 

[powerofpositivethinking]

It looks like the old AGA test was run.  Are you able to call the doctor and see if they will run the newer more specific test for celiac called the DGP (Deamidated Gliadin Peptide) IgG test?  Low total IgA levels can happen in 2-5% of those with celiac.  Check out this link:

 

Open Original Shared Link

 

Since your daughter is IgA deficient, all of the IgA tests will be useless, so please try and get her DGP IgG tested.  Even though this study was on children 2 and under, hopefully it will give you some more information.

 

Open Original Shared Link

 

good luck!

 

My 5 year old daughter had a blood test for celiac by her pediatric GI due to cronic constipation and heart burn.  Both her IGA and TTG are normal but her total IGA was below normal and her IGG came back as a strong positive.  Her doctor gave us a couple of choices, 1) we can get an endoscope to look for damage from celiac and if there is none he's fine waiting 2 years for another blood test, or 2) we can wait and get another blood test every 6 months or so.  He did recomend trying a dairy free diet while we decided what path to take for the celiac testing.  Can anyone tell me what the numbers below might mean for someone this young?

 

Anti-Giladin IGG: 33 strong positive (20-30 is a weak positive, 31+ is a strong positive)

Anti-Giladin IGA: 1 negative (normal is 0-19)

TTG IGA: less than 2 (negative is 0-3)

Total IGA: 42 (normal is 44-89)

[Cara in Boston]

My son was only positive on the IgG tests (Anti-Gliadin IgG and TTG IgG)  as well.  To make it more confusing, his total IgA level was normal.  His only symptom was a drastic change in behavior.  No classic GI symptoms, no malabsorption issue . . . really in quite good health.  She sent us to GI specialist who was also confused.  He did a genetic test which only added to the confusion.  He was found to be "low probability" on the genetic test.  He said no celiac.  By this time I had read a few books on Celiac AND I myself had a positive blood test (and ALL the classic symptoms) so I knew better than to accept his diagnosis without him being able to explain the high IgG tests.

 

We took him to the celiac clinic at Children's Hospital and they ran the DGP tests on him.  Again, the DGP IgA was negative, the DGP IgG was positive.  He had an endoscopy and was found to have extensive damage.  

 

I don't know why doctors want to wait for damage.  Your child's blood tests clearly indicate she has an issue with gluten - and she has uncomfortable symptoms that might be relieved if she just changes her diet!  A better approach (but I'm no doctor, just a mom) would be to have the endoscopy (it is just easier to have a firm diagnosis) and if it is negative, try the diet and consider it the "final" test.  If her symptoms go away, you'll know for sure.  A knowledgeable doctor would take the positive blood test and positive response to the diet as enough information to give you a diagnosis.   The blood tests rarely have false positives.  The biopsy can only confirm celiac.  It cannot rule it out.  A negative biopsy does not mean you don't have celiac, it only means damage was not found.

 

Good luck to you.  It is very frustrating going through the testing and continuing to feed your child something that may be harmful.  Our testing took over 4 months to complete.  Within days of going gluten free it was like we had a new kid.  Joe was 6 when diagnosed.

[GottaSki]

I agree with Cara.  Have the endoscopy and remove all gluten to monitor her symptoms regardless of the biopsy results

 

With her Total Serum IgA low, the IgA antibody based panels will likely never be accurate or positive.  She should have both tTG-IgG and DGP-IgG now before removing gluten, at three months gluten-free, six mouths gluten-free and then annually after her levels have fallen back to normal range.   

 

A positive dietary response along with improved blood work can be enough for a diagnosis.

[cmc811]

Cara - how did you get them to run the IGG tests with a normal IGA? Our pediatrician, whom I normally love, thinks that Celiac is highly unlikely for my very symptomatic son because his IGA was normal and his TTG-IGA was less than 1 (under 4 normal).

 

No known family history until I got tested....my ttg was 7 and my biopsy is next week. I'm at such a loss for what to do with my son!

[nvsmom]

Ditto the others. A positive test is a positive test. She definitely has problems with gluten (gliadin) if she failed the AGA IgG test. That test is not often run because it is not that sensitive and it commonly misses celiacs, but it caught her. See pages 8-12 of this report for more info on the tests: Open Original Shared Link

Low IgA is more common among celuacs than the regular population, so that's a slight nod in the celiac disease diagnosis as well.

Get the other blood tests, do the endoscopy, and go gluten-free. Make sure to give the diet a good six months before judging the diet though, many symptoms take a long time to improve - my constipation took over a year to settle out.

Two of my kids were quite symptomatic too. In fact I tested myself after researching my oldest son's symptoms. Anyway, all of them had a negative tTG IgA with normal IgA levels. My doctor refused to run more tests inspire of the fact that their mom, me, was diagnosed. My choice was to keep feeding them gluten and retest in a year or two, or go gluten-free now, which is what we did. At the very lest they are gluten intolerant as they are doing much better now that thy are gluten-free, but my guess is celiac disease since it's in the family. I think my doctor thinks it is all just a coincidence.

Best wishes.

[Cara in Boston]

The initial blood panel just happened to include the IgG tests.   There was the total IgA, Anti Gliadin IgA, TTG IgA, Anti Gliadin IgG and the TTG IgG.  I guess we just lucked out.   When I asked the "jerk" doctor who said he could not have Celiac because his IgA tests were negative to explain the high IgG numbers his answer was, "lab error?"

 

My sister in Kentucky and my brothers (one in Idaho, one in Colorado) all got screened but NONE of them got any IgG tests done.  They all "think" they are negative, but each one has symptoms.  I keep pointing to Joe as an example of how you can have it but not test positive on the most basic test and they just don't seem that concerned.  I think they would rather deal with the symptoms than deal with the diet.

 

Interestingly, my blood tests were only positive on the IgA tests and perfectly normal on the IgG tests . . .

 

If there is a first degree relative with it, you should get the full panel of tests.

 

I have an older son who had all negative blood tests.  Our doctor at the celiac clinic STILL ordered an endoscopy for him because he seemed to have an issue with his tooth enamel that is characteristic of celiac disease.  With a mother and brother with it, that was enough.  It came back negative.  However, we are supposed to have his blood checked every two years - even if no symptoms develop.  

 

Trust your instincts and keep looking.  With very little research, you probably know more about Celiac than most general doctors.

[seezee]

I have "silent" celiac and am IgA deficient. My doctor misread my tests 4 years ago when I asked to be tested after my daughter was diagnosed in 2009. I asked her to check again a year ago and the IgG was positive - the rest she thought were normal. After she called and wasn't sure what that meant since IgG is non-specific, I decided to go to the celiac clinic at Beth Israel where they followed up with the anti-DGP test. This is what they told me (I think). If IgA is low then the TtG test is useless since TtG is a type of IgA. The IgG is non-specific to celiac, but IgG high combined with IgA defficiency is indicative of celiac since celiac can cause IgA deficiency... The anti-DGP is less sensitive but highly specific. If DgP is positive then you have celiac 99% of the time. Anyways, the lesson is that regular doctors can be very confused by lab results. Even the specialists were confused by the results from the primary physicians labs bc they used non-standard notation and failed to flag the very, very low IgA as abnormal which is why my doctor wasn't aware this made the low TtG useless. The doctors had to contact the lab to interpret the results from the tests my primary doctor gave. The GI/celiac specialist says doctors often misinterpret results. Anyways, anti-DgP was positive and biopsy positive.