Iga Deficient And Igg High?

[heliosue]

I'm about as new as one can get, both to my Celiac diagnosis and this forum. I'm afraid I might be going over old questions and answers on this forum, but I couldn't find what I was looking for.  The following are the results from recent lab work and other than being generally confusing because the results appear to contradict each other, I am having trouble trying to convert and compare my results with others I find here and there on the Internet.

                    Test Name                                Results           Reference Range

 

        Gliadin   (Deamidated)  AB, IGA                   5                    U

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        Gliadin   (Deamidated)  AB, IGG                   1                    U

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        TTG                               AB, IGG                  10                   5 U/ml

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        TTG                               AB, IGA                  <1                   3  U/ml

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Reticulin IGG W/RFL Titer

                            Reticulin IGG Screen            Negative 

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  Endomysial  Antibody Screen (IGA)               Negative            Negative

           W/RFL To  Titer

 

If anyone can shed some light on these results I sure would appreciate it.  My Internist will refer me to a specialist if I ask but I'd like to better understand these results so that I know what to ask.  BTW, I have many of the multitude of symptoms that are listed as possible Celiac related.  Thanks for any help.

Heliosue

[nvsmom]

Welcome to the board.  

 

The reticulin tests are quite old and not many doctors use them anymore.  I don't believe they were the most sensitive tests and they missed some celiacs.

 

Your tTG IgG is twice the normal upper limit.  That's pretty significant.  That test has a specificity to celiac disease of over 95% (meaning out of 100 positive tests, over 95 are caused by celiac disease, and <5 low positives are caused by other health issues) and since your result is a strong one, it is probably celiac disease.

 

You have a negative tTG IgA but many people I see with a positive IgG based test often are - I have no idea why.  The tTG IgG based tests are very important if the patient is deficient in total serum IgA because if IgA is low then all IgA based tests (tTG IgA, DGP IgA, EMA IgA) will have a false negative.  Was your IgA (immunoglobulin A) levels checked?

 

The EMA IgA is very rarely positive if the tTG IgA was negative (even in celiacs).  A better test for you would be the EMA IgG, but I don't think all labs do it.

 

Do you know what the U means with regards to your DGP tests?  I've never seen that before.  As a general rule, the DGP tests seem to have ranges of 0-4, 0-5, occasionally 0-10, and often 0-20.  You'll need to find out what the normal ranges were.  Can you call and ask?

 

If they are referring you to a GI specialist, they must suspect celiac disease based on your positive tTG IgG, and I agree.  The Gastro will probably want to retest you and schedule an endoscopic biopsy.  If you do have the procedure done, make sure they take at least 6 samples, and that you have been eating gluten in the 2-4 weeks prior to the endoscopy.  Unless your appointment is many months away, it is probably a good idea not to go gluten-free yet because that will eventually cause false negative results in almost all celiacs.

 

I like this report for more info on the tests (pages 10-12):  Open Original Shared Link

 

Best wishes.  

[heliosue]

nvsmom.   Thanks so much for the quick (and very informative reply).  That (U) designation is one of the the areas I was confused about. Maybe you can make some sense from the reference ranges that I didn't include in my original message.

 The report shows that the reference range for the DGP  (IGA) is: < 20 units  Antibody not detected and > or = 20 units Antibody detected.  For the DGP  (IGG) the reference range is the same as for the (IGA).  I just can't find how to convert units to something more useful for me to understand.

 I'm not seeing anything in the report that mentions an (IGA) level so I guess that wasn't measured.

Am I correct in guessing that my results indicate an IGA deficiency or am I way off base on that theory?

 

I just checked out and downloaded the PDF from  Open Original Shared Link and I will read through it this afternoon.

Thanks again for taking the time to send me this helpful information.  I do appreciate it.

[nvsmom]

So your DGP tests are fine then if the range is up to 20. Keep in mind though that most celiacs around here were not positive on every single test, it is usually only a few so people get confused about their diagnosis - and rightly so.

Your results do not indicate an IgA deficiency but it is a possible factor that could be affecting your results. Approximately 5% of celiacs are low in IgA, so that is 1 in 20. In the regular population it is much lower. The last stat I saw put it at about 1 in 700. Because lw IgA is more common in celiacs, it is a test that should be run with the celiac disease blood work.

If you can get your immunoglobulin A measured, I think it would be a good idea. Talk to the gastro, I am sure he'll agree to do it.

Hang in there. Waiting is the hardest part in the diagnostic process.

[heliosue]

Once more, thanks for your help.  I assume the Immunoglobulin A test would flag deficient IGA?  Anyway, I'll ask to have that included in my next blood test.

 

Heliosue

[nvsmom]

Once more, thanks for your help.  I assume the Immunoglobulin A test would flag deficient IGA?  Anyway, I'll ask to have that included in my next blood test.

 

Heliosue

 

Yep, you got it.    If it is low, it will "comfort" your doctor when he is looking at your negative DGP IgA and tTG IgA - it explains why a negative would happen.  Just remember that celiacs can have negative IgA based tests with normal IgA (Immunoglobulin A).  It isn't the majority, but it isn't rare by any means.