Test Result Confusion

[TREX]

Hello, I'm new here and I've been reading a lot but I can't find anyone with similar test results. I went to the doctor for a physical recently and thought to mention some minor stomach discomfort. My doctor prescribed me a laxative and that was that. But I got a call later about my hemoglobin count being disturbingly low and my doctor says I have iron deficiency anemia. So great now I get a prescription for iron to take several times a day. But then I get another phone call saying my lab results came back positive for Celiac Sprue so I have to stop eating gluten. I asked for a copy of it and it doesn't look conclusive to me and I was wondering if anyone else had similar results and could interpret this:

Tissue Transglutaminase Antibody, IGG, IGA:

tTG IgG Ser-aCnc: Value 3 U/mL

<6 No antibody detected
> or = 6 Antibody detected

tTG IgA Ser-aCnc: Value 9 U/mL

<4 No Antibody Detected
> or = 4 Antibody Detected

So it looks like a negative result for the IgG and a positive for IgA. But I'm not sure what that means. I haven't  ever eaten gluten free but I would probably describe my diet as gluten light most days. 

[cyclinglady]

You just need one positive and you were lucky they caught it. The next step is to get an endoscopy and intestinal biopsies to confirm. Here is a link to the University of Chicago's celiac website that explains celiac disease and testing. Keep eating gluten until all testing is complete!

Open Original Shared Link

Welcome to the forum!

[nvsmom]

Welcome to the board.  

 

I would say that the majority of celiacs are not positive in all of the celiac tests done, that's why (good) doctors run so many.  The tTG IgA is considered to be one of the most reliable for diagnosing celiac disease, and is, by far, the test most widely used.  The tTG IgA (tissue transglutaminase immunoglobulin A) has a specificity for celiac disease of 95%, which means that 95% of all positives are caused by celiac disease; the remaining 5% are caused by other issues like diabetes (T1), crohn's, colitis, liver disease, thyroiditis, or a serious infection.  False negatives don't happen for no reason.

 

The ttG IgG is considered to be much less sensitive for celiac disease than the tTG IgA.  The IGA part of our immune system is based in the mucosal membranes like the mouth and intestines, whereas the IgA part of our immune system is body wide - it makes sense to me that the tTG IgA would be better at detecting celiac disease (than the tTG IgG) for  that reason.  The sensitivity of the tTG IgG is somewhere around 40%, which means it can miss up to 60% of all celiacs... My guess is that this is what happened to you.  

 

Take at look at this article: Open Original Shared Link It discusses the tTG IgG test.

 

If you doubt the diagnosis, you could always ask for confirming tests (before you go gluten-free).  These tests are left:

• DGP IgA and DGP IgG (deaminated gliadin peptides)
• EMA IgA (endomysial antibodies)
• AGA IgA and AGA IgG (anti-gliadin antibodies) - older and less sensitive tests
• endoscopic biopsy - ensure 6+ samples are taken

This report has more info on the tests:  Open Original Shared Link Please note that none of the tests are 100% sensitive.  Most will miss at least 20% of all celiacs, including the biopsy.

 

I was diagnosed with a positive tTG IgA and EMA IgA.  I skipped the biopsy because those test results are as close to a sure thing as a celiac disease diagnosis can get.  I had celiac disease symptoms so I ran with it.  I'm glad I did.

 

There are over 300 symptoms of celiac disease, and anemia is now considered to be the most common one - that's probably whey they tested you.  Look through this symptom list and see if any others can apply to you... I bet you had more celiac disease symptoms than you realized. Open Original Shared Link

[TREX]

Thank you both!

[jbeilfuss]

Hi TREX,

 

I'm pretty new here too and still in the process of diagnosis as I have my endoscopy this Thursday - thank heavens it's finally nearly here.  Pursue to endoscopy as that is the next stage and since you have not stopped eating gluten containing food, maybe they can get you in quicker for that so long as you keep eating gluten.  I got really sick before my blood test and stopped eating foods with gluten almost two weeks before they did the draw.  I still had two positive tests, but the GI doc said to eat gluten for 8 weeks before the endoscopy - what a drag to hear that!!  So now, I try to eat one serving of it a day up to this test.  You can see the thread I started back in February if you would like see the experiences of a newbie who might be a little further down the curve than you are.  I have tried to chronicle some of what I have experienced so far.  Good luck.