Another post for help understanding test results

[someguy]

Hi everyone, I'm new here and was wondering if anyone could shed some light on recent blood tests while I wait for feedback from my dr.

I had a rough winter with the flu and other sinus infections / bronchitis.  While out of the country, I spiked a fever, had some back pain, nausea, etc.  When I returned, I got checked out by the doctor.  Everything came back OK, but they were concerned over the pains in my side and back.  That had all gone away, but I did the CT scan anyway.  All organs look OK, but they noted a section of small bowel thickening and fat deposits.  This was similar to an image from 10 yrs prior for something unrelated.  My GI recommended a colonoscopy to get a visual and rule out Crohn's.  Procedure was fine and biopsy was normal.  No Crohn's I guess.

The GI recommended a capsule endoscopy to see the upper portion of the GI tract that he could not see with the colonoscopy.  Nothing abnormal again.  He then schedule blood tests to check for Celiac.  Here is what is posted on Patient Gateway:

Immunoglobulin A - Details

Component	Your Value	Standard Range
IgA	201 mg/dL	82 - 453 mg/dL

Tissue transglutaminase IgA - Details

Component	Your Value	Standard Range
TTG IGA ANTIBODY	6.5 U/mL	<4.0 (Negative) U/mL
(NOTE) Interpretation: Weak Positive (4.0-10.0)

Gliadin deamidated antibody, IgG/IgA - Details

Component	Your Value	Standard Range
Gliadin Ab, IGA	13.9 U	<20.0 (Negative) U
GLIADIN AB IGG	87.5 U	<20.0 (Negative) U
(NOTE) Interpretation: Positive (>30.0)

So, it looks like some tests are negative and some are positive.  To make matters worse, I had started a ketogenic diet prior to these tests, so I had not really been consuming gluten since keto greatly reduces carb intake.  The doctor did not mention I needed gluten in my diet and since I wasn't really sure what he was looking for, I didn't mention it.  I'm wondering if some of the negatives would turn positive and my positive would go higher or if it just invalidates the results.  I have never had any of the symptoms that I hear a lot of people describe and have no known family history of Celiac.  This doctor takes forever to get in contact with, so I have an office visit with my PCP next week to make sure I'm not just on a witch hunt.  Clearly I will go gluten-free if I do indeed have Celiac's, but I want to make sure I'm taking the right steps and get a more responsive GI doc.  

Thanks for any insight or comments!

 

[RMJ]

You don’t have to have positives on all the tests to have celiac.  Those values would likely go up if you were eating more gluten.  I don’t know if a capsule endoscopy can detect celiac or not.  The magnification might not be high enough.  A good question for the gastroenterologist. 

[tessa25]

A positive on any one celiac test should lead to a gastroenterologist doing an endoscopy/biopsies to verify celiac. You need to be eating gluten daily until celiac testing is done.

[someguy]

Thanks.  I have a follow up with the PCP next week to go over all of the previous tests and make a plan for next steps.  I left a message for the GI regarding my diet in case he wanted to have the blood test repeated and have me eat gluten.  No response.  It took over 2 months to get the capsule results after leaving voicemail and patient gateway e-mails, so I'm not holding my breath.  I will see if my PCP can recommend someone more responsive for the next steps.