Ig A And Other Ig Test Results

[Catherine.Siena]

I would like your feedback on Ig test results.  I have been having significant GI and other inflammatory symptoms for over three years.  Recently had colonoscopy and two EGDs within 6 weeks of each other.   My acupuncture physician suggested I may have inflammatory disease, perhaps celiac and thought I should try eliminating gluten from my diet and see what happens.  I mentioned this to my GI doctor when going for the 2nd EGD.  At that time he ordered Ig A, Ig G and other antibody tests.  My Ig A came back quite low 30 (range is 80-400), other tests came back within normal limits.  My question is:  if these labs were drawn after I have been gluten free for almost 6 weeks, are the results accurate?  I do feel much better having been off gluten now 8+ weeks, and a lot of my symptoms have improved.  Could this be celiac in spite of the labs, or might something else be going on?  Thanks for your expertise...since I am very new to this site.

[ravenwoodglass]

Welcome to the board.

Being gluten free for six weeks before testing will impact the tests. You need to go back on gluten for a few weeks and then retest if you need a diagnosis. Your total IGA is very low so the celiac related tests for IGA will be negative. So yes you could have celiac even with the negative test results. 

[nvsmom]

  On 5/25/2014 at 2:01 AM, Catherine.Siena said:

I would like your feedback on Ig test results.  I have been having significant GI and other inflammatory symptoms for over three years.  Recently had colonoscopy and two EGDs within 6 weeks of each other.   My acupuncture physician suggested I may have inflammatory disease, perhaps celiac and thought I should try eliminating gluten from my diet and see what happens.  I mentioned this to my GI doctor when going for the 2nd EGD.  At that time he ordered Ig A, Ig G and other antibody tests.  My Ig A came back quite low 30 (range is 80-400), other tests came back within normal limits.  My question is:  if these labs were drawn after I have been gluten free for almost 6 weeks, are the results accurate?  I do feel much better having been off gluten now 8+ weeks, and a lot of my symptoms have improved.  Could this be celiac in spite of the labs, or might something else be going on?  Thanks for your expertise...since I am very new to this site.

 

The IgA and IgG are not celiac disease tests, they are just tests to measure the immunoglobulin (Ig) levels in different parts of the immune system. Low (total serum) IgA levels can be found in about 5% of all celiacs (which is more than the regular population.... Just having low levels of IgA is suspicious enough to sugest the possibility of celiac disease.

 

Ditto everything Ravenwoodglass said, being gluten-free for 6 weeks most likely would cause false negative celiac disease tests, and any IgA based tests (tTG IgA, DGP IgA, EMA IgA, AGA IgA) will be falsely negative. If you want accurate tests you will need to complete a 8-12 week gluten challenge (1-2 slices of bread per day) and only use the IgG based tests (tTG IgG, DGP IgG, AGA IgG). You could also have  the biopsy done; that only requires a 2-4 week gluten challenge.

 

Best wishes!

[Catherine.Siena]

  On 5/25/2014 at 10:21 AM, ravenwoodglass said:

Welcome to the board.

Being gluten free for six weeks before testing will impact the tests. You need to go back on gluten for a few weeks and then retest if you need a diagnosis. Your total IGA is very low so the celiac related tests for IGA will be negative. So yes you could have celiac even with the negative test results. 

OMG what an ordeal you've come through.  Thank you for your response and suggestion.  I will follow up with my GI guy...and better still, an allergist.  It's disheartening to covey symptoms to healthcare professionals, particularly some physicians, and have that feeling that no one is listening, nor do they take the extra steps to put the pieces of the "whole picture" together for their patients.  I am glad you finally got the care you needed!  I hope the same for myself and everyone out there who suffers with these undiagnosed symptoms.

[Catherine.Siena]

  On 5/25/2014 at 2:29 PM, nvsmom said:

The IgA and IgG are not celiac disease tests, they are just tests to measure the immunoglobulin (Ig) levels in different parts of the immune system. Low (total serum) IgA levels can be found in about 5% of all celiacs (which is more than the regular population.... Just having low levels of IgA is suspicious enough to sugest the possibility of celiac disease.

 

Ditto everything Ravenwoodglass said, being gluten-free for 6 weeks most likely would cause false negative celiac disease tests, and any IgA based tests (tTG IgA, DGP IgA, EMA IgA, AGA IgA) will be falsely negative. If you want accurate tests you will need to complete a 8-12 week gluten challenge (1-2 slices of bread per day) and only use the IgG based tests (tTG IgG, DGP IgG, AGA IgG). You could also have  the biopsy done; that only requires a 2-4 week gluten challenge.

 

Best wishes!

Thank you, Nicole...very helpful and I am grateful that you took the time to respond!