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RitaGee44

Test result interpretation negative tTG-IGA, positive DGP-IgG

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My 11 year old has been having his bloods taken due to presentation of various symptoms, lethargy, cramps etc

In particular,  

Transglutaminase-IgA (tTG-IgA) AND deamidated gliadin peptide-IgG (DGP-IgG) antibody tests 

The first tTG-IGA result recorded 0

The first DGP-IgG result was positive

At this point we we were referred to the Gastro, whilst we waited 4 weeks for that appointment we were told to try and eat as much gluten as possible. When we saw the specialist they wanted a second blood test, plus the gene screen before seeing them again soon.

The second tTG-IGA result again recorded 0 (negative)

The second DGP-IgG result was a stronger positive then before.

We’re currently waiting on the gene test results but any insights much appreciated from those results? 

 

 

 

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Hi RitaG,

The IgA and IgG are types of antibodies.  A positive means that antibodies are being produced in the body to attack the gluten eaten ( and the body itself).  Although there are multiple types of antibodies, it only takes one kind of antibody to cause damage.  Since the celiac antibodies are present, the next step is an endoscopy to check for celiac style damage to the small intestine lining.  If the gut damage is confirmed, that is considered proof of celiac disease.

Edited by GFinDC

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Thanks GFinDC,

You explained that well, I’ve been trying to get my head around it, all the abbreviations used throughout the literature just confuses me more!

So one or both positive needs further investigation? Is one type of antibody ‘superior’ than the other when identifying celiac disease? And why wouldn’t both be positive? 

Thanks again for your time! 

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Welcome to the board. You only need one test to be positive to have celiac. Did they test his total IGA? Some folks are deficient and that would make the IGA test useless. As to the gene testing do be aware that while rare there are other genes that are associated with celiac but they usually only test for DQ2 and DQ8. Gene testing is also not diagnostic as there are many with the genes that never develop celiac.

Usually with a positive test they will do an endoscopy. Keep in mind that the small intestine is long and damage can be patchy. A false negative is possible if they biopsy misses a damaged spot. After all celiac testing is done a good strict trial of the gluten free diet should be advised. Do use this time to ask any questions you need about what you need to do when you start the gluten free lifestyle. Also keep in mind that all first degree relatives should be tested for celiac when a family member is diagnosed even if not symptomatic.

Good luck, hope he is feeling better soon and that the doctors can give you clear answers.

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I test positive only to the DGP IgA (had the celiac antibodies tests many times).   Never had a positive on any of the other screening tests, yet my biopsies revealed moderate to severe patches of villi damage.  

https://celiacdiseasecenter.columbia.edu/sites/default/files/Diagnostic-Yield-of-Isolated-Deamidated-Gliadin-Peptide-Antibody-Elevation-for-Celiac-Disease.pdf

It should be confirmed that his Immunoglobulin A (IgA) function is working.  If not, any IgA type test would be invalid.  If he does not make IgA, then you can never have a positive IgA celiac test.  I suppose to save money, it makes sense to run the two tests your son had.  It catches most celiacs, but not all.  

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Hi Rita,

I think you got some good explanations already.  But yes, any positive antibody is a problem.  Some people will be positive on all of them, some won't.  We are individuals and can differ in how our bodies respond to things.  Usually the DGP tests are considered more reliable and accurate.

Another thing to have checked is vitamin and mineral levels.  Since celiac damage can cause malabsorption it is possible to become low on several important nutrients.  Vitamin D and B-12 and iron are some frequent problems.

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Thanks so much everyone! I keep nodding my head with everything you say! His bloods show he is Vit D deficient, low normal in calcium, he also has ‘mild neutropenia’. So all the signs from the reading here seem to point that way, his specialist didn’t seem convinced though. 🤷‍♀️ I’ll be better informed and know the questions to ask now when I see them next, so thanks again, it’s much appreciated. 

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