Test results

[Daiisy]

I'm new to this site but have suspected for a while that I may be celiac. I recently had some bloodwork done and also have an endoscopy scheduled based in my results, but I'm confused. Can anyone help?

My tTG-IgA count is within normal range, as well as my tTG-IgA antibodies; however, my tTG-IgG antibodies are double the normal range. (EMA was not tested.)

This seems unusual to me...from what I've read (thanks, Google) it seems that for a "positive" result, an elevated tTG-IgG antibody level would be expected only if I am deficient in tTG-IgA, which I am not. 

I have had many symptoms consistent with celiac disease for many years: bloat/gas, cramps and pain after almost every meal, eczema/rashes, migraines, etc.  Not sure if it's relevant, but I was also recently diagnosed with cancer (unrelated to skin or any abdominal organs).

Any thoughts? I know that the biopsy will (hopefully) give more solid answers but it's a few weeks away and I'm impatient. (: Apologies in advance for any mistakes in terminology--I'm new to all this!

Thanks in advance,

-D. 

[cyclinglady]

Welcome!  

A positive is a positive and warrants further investigation.  So, it is good that you are having an endoscopy which is still the gold standard in diagnosing celiac disease (sometimes not done for all kinds of reasons like long wait times or lack of funds).  I tested positive to only the DGP IGA and was negative on both the TTG IGA and TTG IGG, yet I had a Marsh Stage IIIB which means significant villi damage.  I guess they do not order an IGG deficiency test due to costs or guess it is rare.  It did not apply to me, so I have not researched it.  

Remember, the blood tests are just tools and are not perfect (very good though).  

Keep eating gluten until all testing is complete and you have biopsy results in hand (in case they botch it and needs  redo!)  even though you want to feel better NOW!  

In the meantime research.  Chances are your doctors will know less about celiac disease than you when it comes with dealing with a gluten free diet.  ?  this will make for an easier transition into the gluten-free lifestyle.  

 

 

[PinkyGurl]

Agree with Cyclinglady you are a really good example of why ALWAYS getting the biopsy is important unless its just not financially possible.  The blood tests are great tools to lead to the biopsy but they have their flaws.  The ultimate and most telling way is getting that tissue sample that shows the damage from celiac.  You are on the right path so good for you!  Since your TTG IGG was positive you can go right ahead and start mentally preparing yourself for your new life.  Just don't stop eating gluten, don't even cut down.  Good luck

[Daiisy]

Thank you for your replies!  I am bracing myself for a gluten-free life moving forward, but I just don't understand my blood test results and was hoping someone may have a hypothesis as to how such a result could occur despite normal overall tTG-iGA levels.  It does seem that, if I were celiac, the iGA antibodies should be up.  Perhaps it doesn't matter in the grand scheme of things but the recent cancer diagnosis has me concerned about every new piece of information that I get. I'm worried that the biopsy will come back negative, which will then leave me with two unanswered questions: 1) what is causing all my symptoms, and 2) what is this crazy tTG-iGA antibody level about? I read somewhere that it could also indicate liver issues...anyone have this happen to them?  Thanks in advance, -D.

[cyclinglady]

I am sorry to hear about your cancer.  It could be completely unrelated to a possible celiac disease.  

I would not worry about your seemingly wacky TTG results.  My own GI can not explain why I test negative to to the two TTG tests even in follow-up testing.    My research has found that this is common in small children and I am old!  Never-the-less, I still have celiac disease which has resolved on a gluten free diet.  

I would imagine that a standard liver panel would show any abnormalities (but I am not a doctor).  

You can ask for an EMA test or you could ask for an IGG deficieny test.  But I think the second option is unnecessary.  Remember, the IGA deficieny test is just a control test to see if the TTG IGA test is valid or working when diagnosing celiac disease.  These celiac disease antibody tests are not perfect -- they are just one tool to help your doctor diagnose you properly.  Hang in there.  Be patient.  Soon you will have an answer.