Blood Test Results For 13 Month Old. Help Me Decipher!

[BrandySimms]

TSH 7.23

Calcitriol 109.3

Vit D. 48.3

T4. 1.02

Lead. <1

CMP. Normal Range

Allergen.

Egg white. <.10

Milk. .14

Wheat. .21

Soy. <.10

Antigliadin Abs, IgA. 1

Antigliadin Abs, IgG. 2

t-Transglutaminase (tTG) IgA <2

t-Transglutaminase (tTG) IgG <2

Immunoglobulin A, Qn, Serum 5

I know the top tests don't apply, but I included them anyway.

I posted before that the GI dr wants to do an endoscopy to test for celiac and I wasn't comfortable with that. What exactly does this blood test show?

[ravenwoodglass]

If you post the reference ranges for the tests folks will be able to be more helpful.

[cyclinglady]

The reference ranges would be helpful as they vary from lab to lab. However, the TSH result is high indicating hypothyroidism. It should be between a 1 and a 3. Old ranges used to go to a 5.9, but your child's result is still high. Could explain the constipation you posted earlier. Fatigue is another symptom, but in a toddler, it might be hard to catch that one!

[StephanieL]

I thought the same thing with that TSH!  Autoimmune issues like thyroid and Celiac often run together so I think this is even more evidence that you really should consider the scope.

[nvsmom]

Ditto, that TSH is high regardless of any normal range I have ever seen.  That would warrant checking the TPO Ab, and Free T4 and Free T3 (which should both be in the 50-75% range of the labs normal range).

 

The antigliadin tests (AGA IgA and AGA IgG) are not very good celiac disease tests. They can miss a huge portion of celiacs - the AGA IgG can miss as much as 80% of celiacs as seen here: Open Original Shared Link

 

The Immunoglobulin A (IgA) looks like it could be low (but I couldn't say without the range). The range seems to often go down to 40 for young kids so 5 would be low.  If the IgA is below normal, as it is in 5% of celiacs, that will cause false negative in all IgA based tests (like the AGA IgA, tTG IgA, EMA IgA, DGP IgA).  You'll want to know if that is normal.

 

It looks like the tTG IgA and tTG IgG are normal, but if her IgA is low it will cause a negative tTG IgA in almost all celiacs.

 

The deaminated gliadin peptides (DGP IgA and DGP IgG)  tests are superior tests for detecting celiac disease in young children. If you strongly suspect celiac disease, I would recommend getting those tests done (not the DGP IgA IF her IgA was low).

 

The endoscopic biopsy is often a good idea for patients with low IgA as the blood tests may not be reliable, plus celiac disease tests are not perfect and even the good ones miss up to 25% of celiacs.  Doing the endoscopy might be a good idea... And I normally don't say that if the tests are clear, and these are not.

 

Good luck!