Explain Test Results Please

[zoesmom13]

Hello,

I am new here. My daughter (almost 3) has been experiencing chronic constipation since she was a baby. The pediatrician had her on miralax to manage it, but of course I just knew something was wrong because everything I tried to ease her symptoms did not work. I knew there had to be an underlying issue. Additionally, I need to figure out her bowel issues if I want to have any hope of ever potty training her. She recently just got tested for Celiac, and I also cut out gluten around the same time, and for the first time in her life she doesnt need miralax to "go"! Her numbers came back, and I believe she is positive for Celiac, but her GI is not open on Mondays. Would anyone explain to me what these numbers mean? Ive googled but it is overwhelming and I feel that Im confusing the different tests. Thanks so much!

 

Celiac Disease Panel

 

Test Low Normal High Reference Range Units Endomysial Antibody Iga     Positive Negative   T-Transglutaminase (Ttg) Iga     18 0-3 U/mL Immunoglobulin A, Qn, Serum   52   19-102 mg/dL

 

[GFinDC]

On 10/10/2016 at 3:00 PM, zoesmom13 said:

Hello,

I am new here. My daughter (almost 3) has been experiencing chronic constipation since she was a baby. The pediatrician had her on miralax to manage it, but of course I just knew something was wrong because everything I tried to ease her symptoms did not work. I knew there had to be an underlying issue. Additionally, I need to figure out her bowel issues if I want to have any hope of ever potty training her. She recently just got tested for Celiac, and I also cut out gluten around the same time, and for the first time in her life she doesnt need miralax to "go"! Her numbers came back, and I believe she is positive for Celiac, but her GI is not open on Mondays. Would anyone explain to me what these numbers mean? Ive googled but it is overwhelming and I feel that Im confusing the different tests. Thanks so much!

 

Celiac Disease Panel

 

Test Low Normal High Reference Range Units Endomysial Antibody Iga     Positive Negative   T-Transglutaminase (Ttg) Iga     18 0-3 U/mL Immunoglobulin A, Qn, Serum   52   19-102 mg/dL

 

Hi Zoesmom,

There is more information on testing at the link below.  I pasted in a small section of the text that should answer your question.  The ttg IgA being positive means there is an immune response to gluten going on.  There are other blood antibodies they can test for also.  Usually the blood tests are followed up by an endocscopy to check for gut villi damage.  Your child should continue eating gluten until all testing is completed.  Sometimes the GI won't do an endoscopy on such a young child.  the serum IgA is a test to be sure the person is actually making IgA antibodies in general.  Some people are not able to make IgA antibodies so the serum IgA is used to identify those people.  If your body doesn't make IgA, the IgA antibody tests are useless.  If the person doesn't make IgA they switch to doing the IgG tests instead.

Open Original Shared Link

Find out for sure

Antibody tests are accurate only when a patient is on a gluten-containing diet. Those concerned about celiac disease are strongly discouraged from starting a gluten-free diet without having had a firm diagnosis. Any change in the diet, even as briefly as a month or two, can complicate the diagnostic process.

Screening test

Anti-tissue transglutaminase (tTG-IgA)

A screening test is commonly used when an individual is in a risk group for celiac disease, whether or not he or she has symptoms. The tTGIgA test is usually the one offered for celiac screening events, as it is the most sensitive test available. In fact, it is generally believed that about 98% of people with celiac disease have a positive tTG test. While the tTG test is very specific, it also can produce false positive results on occasion. Indeed, some people with Type 1 diabetes, Hashimoto’s thyroiditis, and autoimmune liver conditions are especially likely to have elevated tTG without having celiac disease.

[zoesmom13]

6 minutes ago, GFinDC said:

Hi Zoesmom,

There is more information on testing at the link below.  I pasted in a small section of the text that should answer your question.  The ttg IgA being positive means there is an immune response to gluten going on.  There are other blood antibodies they can test for also.  Usually the blood tests are followed up by an endocscopy to check for gut villi damage.  Your child should continue eating gluten until all testing is completed.  Sometimes the GI won't do an endoscopy on such a young child.  the serum IgA is a test to be sure the person is actually making IgA antibodies in general.  Some people are not able to make IgA antibodies to the serum IgA is used to identify those people.  If your body doesn't make IgA, the IgA antibody tests are useless.  If the person doesn't make IgA they switch to doing the IgA tests instead. they would have to use IgG antibody tests.

Open Original Shared Link

Find out for sure

Antibody tests are accurate only when a patient is on a gluten-containing diet. Those concerned about celiac disease are strongly discouraged from starting a gluten-free diet without having had a firm diagnosis. Any change in the diet, even as briefly as a month or two, can complicate the diagnostic process.

Screening test

Anti-tissue transglutaminase (tTG-IgA)

A screening test is commonly used when an individual is in a risk group for celiac disease, whether or not he or she has symptoms. The tTGIgA test is usually the one offered for celiac screening events, as it is the most sensitive test available. In fact, it is generally believed that about 98% of people with celiac disease have a positive tTG test. While the tTG test is very specific, it also can produce false positive results on occasion. Indeed, some people with Type 1 diabetes, Hashimoto’s thyroiditis, and autoimmune liver conditions are especially likely to have elevated tTG without having celiac disease.

Thank you so much for your reply! So is the Ttg IGA I posted helpful? Or is she going to need more blood testing in regards to this. I really don't want to put her through a biopsy but I know many people will not consider it a diagnoses until one has been done. I'm just so lost.☹️

[zoesmom13]

Also, does the fact she has a positive Ttg IGA plus a positive endomysial antibody test further indicate celiac?

[cyclinglady]

7 hours ago, zoesmom13 said:

Also, does the fact she has a positive Ttg IGA plus a positive endomysial antibody test further indicate celiac?

It means there is a chance of celiac disease.  One positive or two, the next step is an endoscopy.  I know that sounds scary, but it is the "Gold Standard" still in formalizing a celiac disease diagnosis.   Some doctors in Europe are just using the celiac disease blood tests and six months of the gluten-free diet to diagnose.  I wish there was an easier way, but there is not.   Consider a second opinion from an celiac-savvy Ped GI.  That might make you feel more comfortable in whatever decision you make.