Low Immunoglobulin A

[lea01]

Hello all,

 

My children (12 and 10) had their Well Child visits last week. Since there is a history of Celiac Disease and NCGS in my family, I decided to have each of them tested (blood work) for Celiac.
 
The nurse called and said everything came back normal. I asked her to send me a copy of the results. For some reason she failed to send me my son's results, but I see my daughter's says:
 
Tissue Transglutaminase AB, IGA      <1     
Reference range: <4 No antibody detected  > or = 4, Antibody detected
 
 
Tissue Transglutaminase AB, IGG         3
Reference range: <6 No antibody detected  > or = 6, Antibody detected 

 
Immunoglobulin A    48
Reference range: 64 - 246 mg/dL
 
Am I correct that a low Immunoglobulin A value pretty much voids the reliability of the panel? Isn't it possible that she could still have celiac disease? The nurse didn't even mention the low Immunoglobulin A.

 

Thank you.

[squirmingitch]

"There are also several conditions which may yield false negative antibody results. A false negative means that the patient actually has the disease, but the test result is negative. One of the conditions that may give a false negative result is Immunoglobulin A or IgA deficiency. If a patient has a low total IgA level, the antibodies may be falsely low. This is why I always recommend that a patient have a total IgA level drawn at the same time the antibody testing is done. Young children may not make the some of the “anti-self” antibodies, as it takes a somewhat mature immune system to make them. So in a young child, antiendomysial antibody, or the TTG antibody, can have false negative results. An inexperienced lab can misread the anti-endomysial IgA test, which requires someone to read a slide through a special microscope. It is possible that a celiac patient could have a positive antibody test at one lab, and a negative test at another. This is because different labs may use different commercial test kits, which vary in their sensitivity and specificity. And lastly, a person has to be ingesting gluten at the time the antibodies are drawn. A gluten-free diet will make the antibody tests negative."

From:

Open Original Shared Link

 

And

Open Original Shared Link

 

You are correct about the low IgA voiding the panel.

[lea01]

"There are also several conditions which may yield false negative antibody results. A false negative means that the patient actually has the disease, but the test result is negative. One of the conditions that may give a false negative result is Immunoglobulin A or IgA deficiency. If a patient has a low total IgA level, the antibodies may be falsely low. This is why I always recommend that a patient have a total IgA level drawn at the same time the antibody testing is done. Young children may not make the some of the “anti-self” antibodies, as it takes a somewhat mature immune system to make them. So in a young child, antiendomysial antibody, or the TTG antibody, can have false negative results. An inexperienced lab can misread the anti-endomysial IgA test, which requires someone to read a slide through a special microscope. It is possible that a celiac patient could have a positive antibody test at one lab, and a negative test at another. This is because different labs may use different commercial test kits, which vary in their sensitivity and specificity. And lastly, a person has to be ingesting gluten at the time the antibodies are drawn. A gluten-free diet will make the antibody tests negative."

From:

Open Original Shared Link

 

And

Open Original Shared Link

 

You are correct about the low IgA voiding the panel.

Thanks, squirmingitch. I am so frustrated. In doing a little research, it seems that at least mentioning the low IgA when giving me the results over the phone, would have been appropriate. Even if they didn't know where to go from here, I would have looked elsewhere to figure out what to do next. But the fact that she said everything was fine when the report clearly states her IgA is low and "IgA deficiency should be considered", burns me up. Had I not asked for the report, I wouldn't know. It may turn out that she's fine and her level will improve with age, but I would never just assume that. So sorry I'm whining...I've just about lost faith in Western medicine. I have close friends and family members who are doctors and other medical professionals, but I just don't know anymore...

[RMJ]

The low Immunoglobulin IgA voids the IgA result, but the TTG IgG was also run and the low total IgA level shouldn't affect that value.

[lea01]

The low Immunoglobulin IgA voids the IgA result, but the TTG IgG was also run and the low total IgA level shouldn't affect that value.

Thanks, RMJ. So I wonder if that means I need to have the test to get her Immunoglobulin G value as well, to ensure that is normal?

[kareng]

"Home / FAQs / Is an IgA result of 39, where normal is 81-463, considered deficient and could it invalidate anti-IgA tests?

Is an IgA result of 39, where normal is 81-463, considered deficient and could it invalidate anti-IgA tests?

Any level of IgA above 20 mg/dl should make the tTG-IgA test valid, regardless of age"

Open Original Shared Link

Seems like enough. The way I was told, that total IGA test and its normal value is for some other reason. It can be low and still be enough to test for Celiac

[cyclinglady]

Here is my two cents. My TTG was negative and my IGA Test was very high. Only the DGP IGA test was positive yet I had a Marsh Stage IIIB (moderate to severe damage) on my biopsy obtained via endoscopy. My docs agree that my reposts are rare, but it happens.

If there a lot of symptoms, can a full celiac panel be run? My insurance will not unless ordered by a GI.