Help understanding test results

[meolson13]

My 4 yo daughter is suspected of having celiac. We have a consult coming up at the end of the month with a pediatric GI specialist but our pediatrician called them to see if we can get her in for biopsy sooner since she has been pretty symptomatic. I'm confused by her test results. I do have a call into my pediatrician as well but she has been out for a family funeral. Her first test, the ttga one was pretty straight-forward. She had a result of 100, which I understand is pretty high? We just got her EMA test and I thought our doctor and nurse had told me it was positive, so I'm confused on it. I pasted it below. What's throwing me off is the Negative > = 1:320 part. Does that mean the EMA was negative? I appreciate any insight as I want to understand her results before rushing her in for an endoscopy/biopsy and am new to all of this. (Worried mama.)

EMA TITER BLOOD IGA Negative >=1:320  
Comment: A positive serum IgA endomysial antibody indicates the 
presence of gluten sensitivity, as is seen in individuals 
with celiac disease, dermatitis herpetiformis and other 
gluten-sensitive disorders. Correlation with the clinical 
presentation and consideration for other diagnostic tests 
for gluten sensitivity and gluten sensitive enteropathy is 
recommended.A positive serum IgA endomysial antibody 
indicates the presence of gluten sensitivity, as is seen in 
individuals with celiac disease, dermatitis herpetiformis 
and other gluten-sensitive disorders. Correlation with the 
clinical presentation and consideration for other 
diagnostic tests for gluten sensitivity and gluten 
sensitive enteropathy is recommended. 

[GFinDC]

This thread has some discussion about the EMA titer.

https://www.celiac.com/forums/topic/66463-endomysial-ab-iga-screen/

Yes, the IGA test sounds high.  The lab should provide a results range to match them up against.  It only takes one positive antibody to have celiac disease.  Although there are different types of antibodies, IgG, IgA etc, all of them can cause damage.

The endoscopy is used to confirm damage to the villi lining of the small intestine.  She may have trouble digesting dairy also.  Lactaid pills or lactaid milk may help that issue.

Other people in the family may have or may develop celiac disease also.  The genes for celiac are passed down on one or both sides of the family.  Having the genes doesn't make you have celiac.  But it makes you susceptible to possibly developing celiac  at some point in life.

Edited November 16, 2018 by GFinDC

[cyclinglady]

She has a very elevated TTG that is indicative of celiac disease and should be confirmed by obtaining iintestinal  biopsies.  Not positive in the EMA?  Me too.  I did not even have a positive on the TTG.  I tested positive on the DGP IgA.  My biopsies revealed some moderate to severe patches of damage. 

Keep her on gluten until the endoscopy. THIS IS CRITICAL!  Do NOT go gluten free yet!  All celiac testing requires you to be on a full gluten diet.  

I know that is is all scary for both of you.  Your best defense is research!  Look for local celiac groups.   Did you know there is a special celiac camp?  I wanna go!  

Seriously, hang in there.  My daughter does not have celiac disease, but if she had a positive on her blood test, I would not hesitate to have her get the biopsy.  It is nice to have a baseline established and a firm diagnosis.  

 

[frieze]

The ANA is not negative.  if you look closely at the top of the lab report, i suspect you will see headings such as "normal"  and "result".   negative being normal, and your daughter's number under results.   if you can, scan it in and bring here.

[meolson13]

Thank you to those that replied. I heard back from her pediatrician, and yes, her EMA test was positive. I guess the formatting was just messed up so that's why it looked confusing. Apparently it was positive and our pediatrician said that she tests positive with a high titer, > 1:320. I don't know if they just stopped it at that point or what but it sounds like it really doesn't matter as between her TTGA value of 100 and the one on her EMA that she has celiac disease. They are trying to expedite our endoscopy and biopsy so we can get her off gluten since she is so symptomatic. We've probably cut it back more than we should. It's so hard to give her food that makes her sick. The nurse at the pediatric speciality GI clinic told me that if we lived in Europe, her test results would be high enough to skip a biopsy as they have just changed the diagnostic criteria in Europe for children but that here in the U.S. they still use the biopsy as the final test. I'm hopeful we can get her in soon so we have a better understanding of what we are dealing with.