Advice Needed After Positive Blood Test

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Hello, everyone! I recently had a panel of celiac blood tests done and now I'm looking for some advice on how to proceed. My B12 levels were low. My IGA and ANA tests were fine. All of the following reference ranges are 0-20.

 

Gliadin IgG: 19

Gliadin IgA: 4

Tissue Transglutaminase IgA: 11

Tissue Transglutaminase IgG: 22

 

I had one positive result and one that was borderline positive, which makes me think that celiac is likely -- especially considering that I have been on a low-gluten diet for the last five years or so. My fiancé is celiac and has been since before we met, and we usually eat the same meals. I eat gluten maybe once every three days in the form of a tortilla or half a bowl of ramen. Also, a couple of weeks prior to the test, I went fully gluten free for two weeks. From what I've read, that can cause these tests to show lower than they might have otherwise. Is this correct? Is it safe to assume that I have celiac? It also looks like I have another autoimmune disorder (rheumatoid arthritis), but I'm unsure if that could impact these results. 

 

I'd like to know for sure because further testing for celiac isn't appealing to me. Because of some medical conditions I have, I don't think an endoscopy would be super safe and it just doesn't seem worth the risk. I'm planning to just go gluten free from here on out, and have been sticking to the diet since these test results came in a week ago. That being said, is there any reason other than the endoscopy for me to go see a GI? My rheumatologist is great and I'd rather just stick with her unless any of you think a GI could give me something that she can't.

 

Thanks in advance!  

[nvsmom]

Welcome to the board.  

 

You probably do have celiac disease as indicated by the positive tTG IgG and almost positive AGA IgG (anti-gliadin antibodies); and it is possible that your gluten light diet affected the results.  About 5% of positive tTG tests are caused by other health problems like T1 diabetes, crogn's, colitis, liver disease, thyroiditis, or a serious infection.  I'm not sure if RA can cause false positives, but chances are it is celiac disease.  The biopsy would give you a better idea if it is celiac disease, but a negative biopsy does not rule out celiac disease, but simply doesn't support the diagnosis.

 

If you are comfortable going gluten-free without an endoscopy, you don't need to do it.  To confirm your diagnosis, just keep track of your symptoms and how they change over the next 6 months or so (some symptoms can take over 6 months to improve) and then retest somewhere between 6 and 12 month gluten-free.  If you are feeling better, and your tests come down, then you probably have your answer.

 

Are you deficient in IgA?  Low serum immunoglobulin A will cause false negative IgA based celiac tests (tTG IgA, AGA IgA and DGP IgA).  That might be something to check.

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My IGA test was 135 with a reference range of 40-350, so that doesn't seem to be the issue. 

 

Thanks for the advice! Sorta confirms everything that I was thinking, so that's good. Retesting after being on the diet is a good idea, too, and my rheumatologist/GP can order that when the time comes. It shouldn't be too hard for me to stick to the diet, considering I have a seasoned celiac veteran living with me!