Elevated Ttg Igg, Everything Else Normal

[aclcs322]

Hello,

 

I received my celiac test results today, and my doctor wasn't very helpful in explaining any of it.  I have an appointment with a GI in a couple weeks, but was hoping to get some insight before then.  My doctor said I was positive for celiac, which kind of surprised me because I have not had an endoscopy.  

 

As background, my daughter has celiac disease, confirmed with an endoscopy.  I eat mostly gluten free at home, but have been trying to eat gluten in the weeks leading up to my test.  I am not sure if I ate enough gluten, though.  Some days I would eat a slice of regular bread, or maybe a handful of pretzels, or some crackers with gluten.  If I was at a restaurant, I would order a regular meal with gluten (such as a hamburger with a bun), but I don't go out often.   Here are my test results:

 

tTG IgA <1.2 (negative <4)

 

tTG IgG 23.8 (Positive >9)  The comment after this one said, "tTG antibody, especially the IgA, is sensitive and specific for untreated Celiac Disease.  The IgG assay is used mainly to detect celiac patients who are IgA deficient.  Verified my repeat analysis."  However, looking at my IgA level below, it doesn't seem as though I am IgA deficient, right?

 

Gliadin Ab, IgA (DGP) 3.7 (negative <20)

 

Gliadin Ab, IgG (DGP) 2.2 (negative <20)

 

IgA 166 (range 71-397)

 

Is it odd that my IgG levels were positive on one test and negative on the other?  Should I eat lots more gluten before my next appointment?

[powerofpositivethinking]

welcome, aclcs322!

 

You are correct, you are not IgA deficient based on your results.  With your daughter having celiac disease, that should be a red flag to your health care provider.  I'm in a similar situation as you except my DGP IgG was positive, and my TTG IgG was negative.  I am a normal IgA producer and all of my IgA results were negative.  All of the IgG based tests say they should be used for individuals with IgA deficiency or young children.  I fit neither description, and it seems neither do you.  Since your result is double what is considered positive, I would say it is definitely valid.

 

I've done a lot of research on the DGP IgG testing over this past year, and I can tell you from experience there isn't near as much research on the TTG IgG test as the TTG IgA version   Obviously there is something going on in your body, and unfortunately the celiac research doesn't include studies on IgG based tests if you're not IgA deficient.  To say it's frustrating is an understatement, but hopefully with continued research things will become clearer.  I've kept an extremely strict gluten-free diet this last year, and my DGP level is still in the slightly positive range.  I still have a deficiency of Vitamin K and recently my GI diagnosed me with fat malabsoprtion.  Yesterday I got another test back that indicates pancreatic insufficiency, so I've been up researching for my follow-up GI appointment because I can't sleep and that's what I do to cope  Continue to eat gluten until all testing is completed.  

 

I wish I could provide a little more concrete information, but sometimes it just helps to know you're not alone 

 

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[nvsmom]

Welcome to the board.

I would guess that roughly half of our board members had at least one negative test during their diagnosis, whether it be an endoscopy, tTG IgA, DGP IgG, or EMA IgA....but they (usually) had at least one positive test before being diagnosed as a celiac. Getting negative tests is not that unusual - that's why they run so many types of tests.

Doctors tend to think that one needs positive IgA based sets as they re based on the mucosal linings of your body, the IgG has more of an overall autoimmune function but the tests have about the same specificity (how likely a positive indicates celiac) as the IgA ones. The sensitivity (how likely it s to show an accurate positive result) is sometimes less in the IgG based tests but that did nt affect you.

With a family history of celiac disease, and a positive result that is over double the normal limit, I would say it is pretty likely that you have celiac disease. That being said, you should continue eating gluten until testing is complete, as long as the appointment and testing occurs in a timely manner. No doubt the GI will want to do further testing.

Good luck!

[aclcs322]

Thank you both for your input!  It is so hard to wait for my GI appointment to get here, but I am going to take advantage of the wait and eat all of my favorite foods before I can't have them anymore!

[sriraman1]

I have a situation very similar to aclcs322. All other values in Celiac panel OK except elevated TTG AB IGG. (Value of 14).

Would like to know if aclcs322 was confirmed with Celiac and how he/she is doing?

Also does a value of 14 indicate developing or early Celiac?

Would greatly appreciate any information or news.

Waiting anxiously.

[nvsmom]

Unfortunately aclcs322 has not posted for over a year and is not active on the board.  Perhaps try starting your own topic and you'll find more advice.

 

Generally speaking, it is pretty common for a celiac to be negative in some tests but not others.  I don't think your situation is that uncommon.

[cyclinglady]

I was just barely positive on my blood test, yet my biopsy revealed moderate to severe intestinal damage. Plus, my only symptom at the time was anemia! No tummy issues.

The next step is usually an endoscopy, but some skip this step because of long wait times. So, keep eating gluten until you are sure all testing is complete.

I am just two years into my diet and I am feeling great! So, you can get well or at least have significant improvement. I am old, so I am dealing with issues that are unrelated really to celiac disease. Nothing big, just annoying!