Blood test interpretation

[Engineer]

Hi 

Im new here. I've been suffering from GERD and IBS for past two years. I have done several courses of different medicines including PPIs to no avail. I have been researching on celiac desease and gluten sensitivity for past few weeks and out of curiosity I took the tTG and DGP antibodies test.

My results are as follows,

tTG-igA: 8.29 U/ml
tTG-igG: 20.0 U/ml

normal: values less than 12 U/ml
equivocal: values between 12 -18 U/ml
positive: values greater than than 18 U/ml

------------------------------------------------------------------------------------------

DGP-igA: 21.7 AU/ml
DGP-igG: 14.75 AU/ml

normal: values less than 15 AU/ml
equivocal: values between 15-30 AU/ml
positive: values greater than than 30 AU/ml

------------------------------------------------------------------------------------------

so basically my tTG-igG is positive and DGP-igA is equivocal.
how would this result be interpreted?

 

[tessa25]

A positive on any one celiac test should lead to an endoscopy/biopsies being done by a gastroenterologist. You have to keep eating gluten until all celiac testing is done.

[cyclinglady]

Yes, Tessa is right!   Get to a GI for further testing.  You do have an odd result, but it needs further investigation.  Remember, some celiacs are seronegative and some are IgA deficient.  Did your doctor run an Immunoglobulin A  (IgA)?  In celiac disease testing it it used as a control test to validate the IgA tests (e.g. TTG IgA).  You may or may not have celiac disease, but get this checked out.  I personally think IBS means “I be Stumped”.  You deserve decent health! 

Engineers (have a family full of them) love algorithms:

Open Original Shared Link

Edited April 7, 2018 by cyclinglady

[Engineer]

right now im out of city and cant consult with my gastroentologist, I'll consult him when I'll get back.

one more thing, I was on librax and levosulpiride for 3 months on my gastroentologist's prescription. is there any evidence that these meds could have any effect on my lab reports?

[Engineer]

I got blood tested again for total serum igA and tTG tests, a summary of the results is as under,

Total Serum igA: 1.67 g/L        (normal range is 0.4-3.5)

-----------------------------------------------------------------------------------------------------------------

tTG-igA: 9.13 U/ml
tTG-igG: 21.24 U/ml

normal: values less than 12 U/ml
equivocal: values between 12 -18 U/ml
positive: values greater than than 18 U/ml

------------------------------------------------------------------------------------------------------------------

DGP-igA: 21.7 AU/ml
DGP-igG: 14.75 AU/ml

normal: values less than 15 AU/ml
equivocal: values between 15-30 AU/ml
positive: values greater than than 30 AU/ml

---------------------------------------------------------------------------------------------------------------------

As per my research it seems like I do not have a celiac desease. But what does a raised tTG-IgG level indicate? could it indicate non celiac gluten sensitivity?

[squirmingitch]

Why in the world are you discounting the positive tTG-IgG? That is positive. it only takes 1 positive to move to an endoscopic biopsy.

The finding of tTG IgG antibodies may indicate a diagnosis of celiac disease, particularly in individuals who are IgA deficient. For individuals with moderately to strongly positive results, a diagnosis of celiac disease is possible and the patient should undergo a biopsy to confirm the diagnosis.

 

If patients strictly adhere to a gluten-free diet, the unit value of anti-tTG antibodies should begin to decrease within 6 to 12 months of onset of dietary therapy.

From:

Open Original Shared Link

 

There are no test at this time for gluten sensitivity. None. 

[cyclinglady]

I do not get it.  You have had a positive and an equivocal  on the panel.  Okay, no positive to the TTG IgA despite having a normal Immunoglobulin A result.  So what?  I have ONLY had a positive DGP IgA (even on many follow-up tests after my dx), yet I had moderate to severe intestinal damage per my biopsies.  

You can not rule out celiac disease at this point.  Go see a Gastroenterologist would be my advice.  Taking medications to relieve your systems and not finding the root cause of your GERD and IBS is not the way to go.  But I am not a medical doctor, just a person who values feeling good!  

[Engineer]

I will visit my gaestroentologist once I get back home.

[cyclinglady]

I did not answer your question about your medications.  I do not think those drug would impact your results which are measurinng antibodies.  A drug that suppresses the immune system (like steroids) could.  

 I have celiac disease and had some symptoms come up (stomach) despite being gluten free for years.  My blood tests even suggested that gluten was getting into my diet.  Finally, I had a repeat endoscopy.  It revealed a healthy small intestine (so I was doing a good job of being gluten free), but it revealed autoimmune gastritis.  Why I am sharing this?  Because it can be important to find the root cause of your symptoms and not just apply “bandages”.  You can not resolve a problem that has not been properly identified.  Happy to hear you are planning to follow-up with a GI.  

 

[Engineer]

16 hours ago, cyclinglady said:

I did not answer your question about your medications.  I do not think those drug would impact your results which are measurinng antibodies.  A drug that suppresses the immune system (like steroids) could.  

 I have celiac disease and had some symptoms come up (stomach) despite being gluten free for years.  My blood tests even suggested that gluten was getting into my diet.  Finally, I had a repeat endoscopy.  It revealed a healthy small intestine (so I was doing a good job of being gluten free), but it revealed autoimmune gastritis.  Why I am sharing this?  Because it can be important to find the root cause of your symptoms and not just apply “bandages”.  You can not resolve a problem that has not been properly identified.  Happy to hear you are planning to follow-up with a GI.  

 

thanks for your input.

I'll let you guys know after I visit my GI.

[Engineer]

I just visited GI. I have been prescribed small intestine biopsy through endoscopy this week.

[squirmingitch]

Good deal. Keep eating gluten every day until then.

[RMJ]

I hope your biopsy will give you a definitive answer.

[Engineer]

Got endoscopy and biopsy done today.

Biopsy report will take 2 weeks, however, my GI has instructed me to go gluten-free.

[cyclinglady]

Great!  Research all that you can about the gluten free diet.  Personally, I would avoid oats, going out to eat, and processed foods (as much as possible) until you start to see your symptoms start to resolve.  Keep a food journal as you might have permanent or temporary intolerances to other foods (e.g. lactose, corn or soy are common offenders).  

 

 

[Engineer]

as per the report of my endoscopy, all else is normal but my antrum is stated to have "mild gastric erythema"

2 biopsies have been taken, one from antrum and one from deudenum, distal part.

[Ciglee]

See a doctor.  Don’t self diagnose.   

[cyclinglady]

On 6/2/2018 at 12:01 PM, Engineer said:

as per the report of my endoscopy, all else is normal but my antrum is stated to have "mild gastric erythema"

2 biopsies have been taken, one from antrum and one from deudenum, distal part.

The endoscopy can be completely normal.  It is just a visual and he could have an older scope.  Mine was normal.  You will have to wait for the pathologist’s report on the biopsies.  Unfortunately, the GI  only took two biopsies  which is not what the American GI Association recommends when testing for celiac disease as damage can be patchy.  I guess he is assuming you have celiac disease since suggested going gluten free before all reports are in.  

 

[cyclinglady]

2 hours ago, Ciglee said:

See a doctor.  Don’t self diagnose.   

The OP just had an endoscopy and biopsies.  He probably saw the endoscopy report on his patient portal and hasn’t had the chance of seeing his doctor yet.    Consider reading the entire thread before jumping to conclusions.  ?

[Engineer]

On 6/4/2018 at 8:10 PM, cyclinglady said:

The OP just had an endoscopy and biopsies.  He probably saw the endoscopy report on his patient portal and hasn’t had the chance of seeing his doctor yet.    Consider reading the entire thread before jumping to conclusions.  ?

yup

my next appointment is scheduled after two weeks. I have been instructed to remain gluten free for the time being.

[Engineer]

my biopsy report has been recieved.

there are no signs of villous atrophy in my deudenum as per the report.

my report reveals "mild chronic non specific gastritis" in my antrum.

lets see what my GI has to say about further course of action.

[Engineer]

My GI says I might not be a celiac but I might have other food allergies. Nonetheless she has prescribed the HLA DQ2/DQ8 test for final confirmation.

She has also referred me to an allergy specialist to find out trigger of my GERD.

[cyclinglady]

Thanks for keeping us posted.  Your comments will help others.  I am glad that your doctor is being so thorough.  

[pupppy]

Did you have it?