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zizgal

Blood Test Results In A 3 Year Old

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Hi, can someone help me understand my 3 year old's bloodwork? He's been having diarrhea since september. We've figured out he's lactose intolerant, but he's still having loose stools every few days after going lactose free for the past 6 weeks. His growth curve looks perfectly healthy. His stool culture came back negative for infectious stuff. I asked the pediatrician to run the celiac blood panel to rule it out before trying him on a gluten-free diet. She told me the bloodwork came back negative and ruled out celiac. I asked to see the results anyway, and it is "weakly positive" for one thing: TTG IgG

 

So is the pediatrician right or wrong to rule out celiac?

 

Here's the results of the full panel

 

Deamidated gliadin, IgA  3 (negative)

Deamidated gliadin, IgG 2 (negative)

TTG IgA <2 (negative)

TTG IgG 6 (weakly positive range 6-9)

EMA IgA negative

Immunoglobulin A, Qn, Serum    102  (normal 44-189)

 

What do you think? Should I keep feeding him gluten for now and follow up with a gastroenterologist? (The earliest appointment is a month away!) Or am I just being a crazy neurotic mother??
 

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I don't think that you are a neurotic mom. He has symptoms and a positive test. To e, it makes sense that you would look into it more.

The tTG IgG is very specific to celiac disease, 95% of positives are caused by celiac disease, so it is likely that he has celiac disease. Some people, young children and those with early celiac disease, will end up with false negatives (as high as 25%) so that could account for the other negatives. I would say, based on what I have seen around here, that around half of all celacs end up with a negative blood test, whether it is blood or endoscopic biopsy. It really can confuse things...and doctors. Lol

False positive tTG IgG tests can happen but they are not common. It is much much more likely to get a false negative with this test. False positives in the tTG IgA version are caused by thyroiditis, diabetes, crohn's, colitis, chronic liver disease or a serious infection. If they don't think he has celiac disease, they might want to look into these problems... But if it looks like a duck, and quacks like a duck, it s probably a duck. ;)

The only test left to be done is the endoscopic biopsy. He needs to et gluten in the 2-4 weeks prior to the test, between 1/2 to 2 slices of bread per day - it sn't much. Ensure at least 6 samples are taken because the biopsy can miss up to 1 in 5 celiacs. I would go a bit lighter on his daily gluten until the test approaches. It could help him feel a bit better.

If all tests are negative, try the gluten-free diet for 6 months anyways. If he feels better, that's the main thing, right?

Welcome to the board.


Nicole 

"Acceptance is the key to happiness."

ITP - 1993

Celiac - June, 2012

Hypothyroid - August, 2012

CANADIAN

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