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Heather G

My son's tests results - confused!

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Hello!  Hoping I can get some input regarding my 11 year old son's test results.  Primary care doc said the results may indicate celiac, but pediatrician that he sent us to said he was happy with the results and that my son was definitely not celiac.  After the research I have done, I was shocked at that response.  He also said that no gastroenterologist would biopsy based on these results.  I would greatly appreciate any advice!

Ttg Iga - 12.9 (0.0 - 19.9 normal)

Dgp Iga - <5.2 (0.0 - 19.9 normal)

Dgp Igg - 82.8 (0.0 - 19.9 normal)

My son has fatigue, joint pains, difficulty putting on weight.  Initial blood tests indicated low iron and elevated liver enzymes (which led me to request celiac screen).  

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Wow! Not a doc, but if 82 (extremely high) does not indicate celiac they wouldn't use it for celiac testing. Send a copy of these results to a gastroenterologist so they can either diagnose based on that or do an endoscopy before your son goes gluten free.  I don't understand why the primary sent you to a pediatrition instead of a gastro after seeing those results. At least now you know what pediatrition to avoid. Lol

 

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Welcome.  

I can see the hesitation since just the DGP Igg is positive.  It is not a common result.  Was he tested for an IgA deficiency?  That test, when in conjunction with the celiac tests,  is used as a control test (to see if any IgA tests are working properly).  If the IgA deficiency were negative it could explain the low results on the other tests.  Perhaps you left it off your posting?  

In any case, a positive is a positive and a GI referral is the next step.  I can tell you that my CD test result was a positive on ONLY on the DGP IgA, yet my biopsies revealed moderate to severe damage.  

http://www.mayomedicallaboratories.com/it-mmfiles/Celiac_Disease_Diagnostic_Testing_Algorithm.pdf

Is it possible to get into a GI?  Go back to your PCP and not the Ped?  

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Thank you both for your replies, I appreciate your insight.  The total serum Iga test was not done - I requested that we do it, but the pediatrician said it was unnecessary (will not be  seeing him again!).  Our next step will be a GI -our primary care doc was hesitant to go that route as we do not have a pediatric GI in province.  I will request to see a regular GI.

I find it interesting that the lab ranges are so different for acceptable ttg Iga levels.  The Mayo Clinic positive is >10 u/ml where as our Canadian lab positive is >19.9 u/ml.  My son is at 12.9.

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With the control test (in this case the IgA deficiency test), you do not know if the TTG IgA or the DGP IgA results are even valid.  It is a necessary part of the celiac testing process.  You could also request the EMA IgA test as well.  

Different labs have different ranges, so I would dismiss the Mayo lab ranges.  

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