Tissue Transglutaminase Igg Positive - Alternate Causes?

[appletree729]

I've had a negative biopsy and mostly normal labs from a few years ago.  I asked my doctor to retest recently and everything was normal with the exception of my TTG IgG test which resulted in a strong positive - here are the results:

 

IgA normal - 161 (range 91 - 414)

 

deamidated gliadin Abs IgA - 7 (range 0-19)

 

deamidated gliadin abs IgG - 3 (range 0-19)

 

tTg IgA - <2 (range 0-3)

 

tTg IgG - 14 (range 0-5)

 

I also have a positive genetic test although I know that doesn't mean all that much.  I've been occasionally anemic in the past and have hashimoto's thyroiditis as well, as well as low vitamin D.

 

I have a follow up with the doctor next week and I really would like to know how to approach this - if it's not celiac disease, something is causing the tTg IgG to be elevated, and I'm assuming it would be beneficial to find out what it is...  From what I'm understanding, this test is slightly lower than 90% specific to celiac disease, so there is about a 10% chance that it is caused by something other than celiac disease?  What are those things?  I've read diabetes, liver disease, crohns, or other autoimmune conditions (hashimoto's?)...  I've had a pretty complete blood panel done recently and nothing points to diabetes or problems with my liver.  And my GI doctor said there was no evidence of crohns.  So is it just the hashimoto's?

 

So I'm left wondering if it's worth pursuing more testing (if we missed any blood tests - my doctor didn't seem that familiar with everything and subbed in a different test than the ones I asked for which included the EMA - she said it had been replaced by something else?  I don't know what else off the top of my head, but I got the list from here.  I understand it might not be celiac, but I want to actually know *what* is causing it so I can do what I can to correct it. 

 

If I have celiac disease, I'd really love to have a diagnosis because my children are having issues as well and it would be extremely helpful to know if it runs in the family.

 

I do feel much better being gluten free, so I know I should probably not be eating it, but I want to get answers.  Thanks for any insight.  I have searched around here for some answers but nothing is specific about alternate causes...

[cyclinglady]

I am reading Gluten Freedom by A. Fasano MD this very minute. He states, "the determination of the IgG-based antibodies, the IgG anti-ttg antibody and more recently, the IgG anti-Gliadin antibody (DGP) is useful in patients with selective IGA deficiency." Well, you are not IGA deficient, but you did get that one positive.

Anything could have gone wrong with your previous biopsy results. They could have been mis-handled, the doctor did not take enough samples when the damage could have been patchy or the damage was further down the intestinal tract beyond the reach of the endoscopy.

You do feel better now on the gluten-free diet. Maybe your doctor can give you a diagnosis based on your genetic results, diet relief, positive TTG IGG, and signs and symptoms of celiac disease (4 of the 5 pillars of celiac disease diagnosis which is being disputed now in an attempt to be able to diagnose without an evasive endoscopy).

I have Hashi's. I had anemia. I went for a routine colonoscopy (am over 50). GI suspected celiac disease despite the fact I had no abdominal symptoms and had a genetic anemia already). My TTG tests were negative! I was not IGA deficient. Only my DGP IGA was positive. Biopsies did reveal Marsh Stage III B but visual Endo results looked normal.

I do not think that celiac disease is ruled out in your case. Just another odd case like mine! I hope this helps!

Oh, with that one positive....get your kids tested!

[cyclinglady]

I forgot to ask? What were your lab results a few years ago? Was the TTG IGG positive back then? If so, has it come down?

[appletree729]

Thanks so much for your reply - I'm not sure that the TTG IgG was included in my last round of tests - if it was, it was negative, so if that's the case, it's higher now.  The reason we did the biopsy was because of symptoms (mostly unexplained abdominal pain), the anemia and positive genetic tests, and also because my kids are having so many problems and are suspected of having celiac.  My one daughter had some positive bloodwork last fall - it was *just* positive though, so her GI advised us to keep her on gluten and retest in several months to see if it goes up - which she is due for now.  That was the deamidated gliadin test I believe.

[Ohokaycool]

Hi, I was wondering if you found any answers? I have this exact pattern- the TTG IgG is the only one that's positive, and all the rest negative, and I'm not IgA deficient. My numbers look really similar to yours.  I had two EGD's, each a year apart, which both were negative for celiac (two different doctors; the second one I saw was registered on the celiac disease foundation website too, so i hoped he was experienced).  I also have Hashimoto's and low iron/ferritin, not quite anemic though.  No liver disease. no diabetes. etc. I have been searching for someone else who had this result too.  It has to be more common than we think.  Autoimmunity seems to be a pattern.  My theory is that it is related to leaky gut - the gluten leaks into the bloodstream, which creates antibodies, which also triggers the autoimmune attack on the thyroid.  But I am still searching for answers.  I have tried searching for research studies in which they test the TTG IgG.