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Interpreting Blood Test Results

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My daughter's pediatrician wanted to test her for celiac due to her short stature, her weight, vitamin deficiency, tooth decay, eczema, among other symptoms that she has had throughout her lifetime.  She is 11 years old and weighs 50 lbs, and hasnt gained any weight in a year.  She was gluten free for 2 years (after a wheat allergy was discovered).   I put her back on gluten for 4 weeks prior to having the blood drawn. Lots of gluten daily.   Her pediatrician said it may or may not be long enough to determine if she has celiac, but wanted to go ahead and test her.  Here are her results.  It appears to me that everything is normal.   Should I retest her again after a few more weeks on gluten?  Or does this test tell us that she does not have celiac?

 

Component Standard Range Your Value Flag TISSUE TRANSGLUTAMINASE IGA <4 u/ml <1   Value Interpretation
<4 U/mL: No Antibody Detected
>or=4 U/mL: Antibody Detected IGA 64 - 246 mg/dL 132   GLIADIN IGA, EIA <20 units 5   Value Interpretation
<20: Antibody not detected
>=20: Antibody detected GLIADIN IGG, EIA <20 units 3   Value Interpretation
<20: Antibody not detected
>=20: Antibody detected RETICULIN IGA Negative Negative   RETICULIN IGG, SERUM, QUAL Negative Negative

 

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If I'm reading it right they all look normal. So no celiac by blood test, but doesn't mean she doesn't have it. The gold standard is an EGD with biopsies and aven that can be falsely negative. 

 

4 weeks on gluten should be more than enough to make tests positive.

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Those are old are less reliable tests. The reticulin IgA is rarely used any more, and the anti gliadin tests are not that reliable. The tTG IgA is not a bad test but there are others that should be done like the deaminated gliadin peptides tests (DGP IgA and DGP IgG), and the tTG IgG. Also a total serum IgA should be done to make sure she has enough IgA for accurate tests.

This report has more info on tests: http://www.worldgastroenterology.org/assets/export/userfiles/2012_Celiac%20Disease_long_FINAL.pdf

Hypothyroidism can slow growth down. That might be wrth checking. Growth hormone levels in the form of IGF-1, might be good to check too.

Best wishes.

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