Test Results 3 Year Old

[Mneri]

Hello I would like some help with my son's results

TTG IgA 21 weak positive

TTG IgG negatige

EMA negative

AGA IgAnegative

AGA IgG negative

ARA Negative

IgA normal

Are these results inconclusive?

[cyclinglady]

Well, it appears that you got one positive out of the panel! The AGA tests are older and considered less reliable. The newer DPG tests are better. I personally only had one positive on my panel too. My biopsy via endoscopy showed moderate to severe damage.

It might be worth repeating the panel and including the newer DPG tests. Be sure to keep your son on gluten until all testing is complete! Otherwise, the tests could be invalid/negative. Endoscopy/biopsy is usually the final step in diagnosis. At least six biopsies should be taken.

Kids that small are not as easy to diagnose. I am sorry that the diagnosis process is not easier.

Here is a link to a reputable source and talks all about Celiac disease:

Open Original Shared Link

I hope your son feels better soon.

[StephanieL]

Sorry OP, I have to ask this on the "not easy to dx",  I hear this all the time here.  Is it really that difficult or is it that they may not have as many positives as older people simply because there hasn't been enough time to cause enough damage?  

[cyclinglady]

Based on my limited research and the fact that I am not a doctor or a scientist, I think celiac disease in general can be difficult to diagnose. Nothing is clear cut. I assume that it can be more difficult for a small child as they can not always verbalized symptoms and their parents are often given poor advice from their doctors and many other reasons I am not aware of or have forgotten!

Even the experts (e.g. A. Fasano MD) do not always agree about the diagnostic process and even point out that the process is not set in stone and is evolving. The old five pillars of Diagnosis (and reasons the pillars are not rock solid)

1. Signs and Symptoms compatible with celiac disease (some have no symptoms)

2. Positive Serological blood tests (10 to 20 % fail this)

3. Genetic markers HLA-DQ2 or DQ8 (2 to 3 % of those with celiac disease do not have these genes)

4. intestinal damgage found via endoscopy (damage can be patchy and missed)

5. symptom resolution after going gluten free (there are several possible reasons a person might not respond)

Source: (Fasano, Alessio, MD, "Gluten Freedom", Turner Publishing Company, New York, New York 2014)

The answer to your question about damage not be more advanced? Who knows? Not even the experts can agree. Fansano states "Preliminary studies of children who are at genetic risk of celiac disease have shown that even the best serological marker of the condition that is currently available, the IGA anti-TTG antibody, may flucuate over time from a border line positive to a normal value and vice versa."

Nothing is concrete! Celiac disease is difficult! (Dang, typing on an iPad is difficult! )

My advice is to parents is to research (like you do, Stephanie) and be the best advocate (as you are) for your child (or yourself). I am thankful that this forum allows for discussion and as members we help each other. Someday, medical science will really understand celiac disease (I hope!)

[StephanieL]

I just wasn't sure if there was an actual scientific reasoning to this as I see it mentioned often but haven't seen anything stating "it's harder in kids".

Also, just an a side not, Fassano's 5 pillars DO NOT apply to kids so that's kind of a moot point  

Clear as mud!  Right? lol

[nvsmom]

  On 4/11/2015 at 1:30 PM, Mneri said:

Hello I would like some help with my son's results

TTG IgA 21 weak positive

TTG IgG negatige

EMA negative

AGA IgAnegative

AGA IgG negative

ARA Negative

IgA normal

Are these results inconclusive?

 

 

Hard to say.  A positive tTG IgA is usually (95% of the time) caused by celiac disease.  The rare time a positive is not caused by celiac disease, it is usually a weak positive, and is caused by thyroidiitis, crohn's, colitis, diabetes, liver disease or a serious infection.  If any of those could apply, then that positive may not be caused by celiac disease.

 

Don't go gluten-free until all testing is done (ike DGP IgA, DGP IgG, endoscopic biopsy).  Once testing is done, and if it is still inconclusive, have him go gluten-free for  6 months to see if it helps.  After being gluten-free, retest after 6 months and see if your results go down.  That would point to celiac disease.

 

You could also do the genetic tests.  97% of celiacs have the DQ2 and or the DQ8.

 

 

And from what I have read, they suspect childhood celiac disease is harder to diagnose because it is early celiac disease.  They may not be serologically sick enough yet.  

[Mneri]

Thank you all we have an appointment with the gastro in a couple of weeks. We really don't want to do an endoscopybut we'll see what she recomends.