Need Help with Lab Results

[LostRiverSu]

My 9-year old was diagnosed with Hypothyroidism (autoimmune - Hashimoto's) 3 years ago after abrupt weight gain & family history clued us in to check on it. Her thyroid labs are now great but she's had persistent small red bumps/little rashes that come & go, crazy-dry skin and weight gain. She also has some stomach issues--gassy & stomach aches/loose stool often. She is very, very tall, too. I took her to an allergist and the needle test on the back only showed a reaction to eggs & egg white. However, he ordered a celiac panel & egg panel blood work. The lab messed up and didn't run the egg panels (ugh), but did process the celiac panel. The allergist's nurse read me his note that it should be looked into further and made an appointment to see her in May. I don't want to wait that long just wondering like a crazy person, so I was hoping some experts here can help. I'm not sure if the 1 result that was slightly elevated could just be from her thyroid antibodies...? Here were her results: IGA w/reflex to Tissue Transglutaminase IgG Ab  Result: 182.00, Ref. Range: 30.00 - 220.00 mg/dl.  Tissue Transglutaminase (TTG) Antibodies IgA Result: 0.6, Ref Range: ,0.5-14.9 U/ml.   Deaminated Gliadin Antibody, IgG Result: 18.2 Ref Rage: <0.4-14.9 U/ml.  Deaminated Gliadin Antibody, IgA Result: 2.3, Ref Range: <0.2-14.9 U/ml.

Thanks!

[Ranchers Wife]

I would suggest that you get a good copy of the celiac antibody testing, and do your best to get an appointment with a very good pediatric gastroenterologist, or just a very good gastroenterologist.

That might be by referral from the allergist, or her pediatrician perhaps. 

 

[cyclinglady]

Those lab results are weird.  I have never seen anything like it.  Ranges for the antibodies?   Call the lab or ask the doctor.  But it only takes one positive on the celiac panel to move forward.  I personally test positive to only the DGP IgA and I had severe intestinal damage and had long been diagnosed with Hashimoto’s.  

Hashimoto’s is common to have with celiac disease (I have both).  The dry skin and rashes could be attributed to both.  The GI upset, that might be celiac disease.  Ask for a Gastroenterologist referral and keep her on gluten as the next step is an endoscopy to obtain small intestinal biopsies.  Do not start her on a gluten free diet or the rest of the testing will be messed up!  

I hope she feels better soon.  I would not wait.....she is sick!  

Edited April 12, 2019 by cyclinglady

[LostRiverSu]

Thank you both so much for responding to my questions. So, it is possible that she could have celiac disease or gluten intolerance with just the slightly elevated Deaminated Gliadin Antibody, IgG ? I had read somewhere that if the TTG is negative, it's unlikely she would have celiac but now that doesn't sound right... I'm just so nervous to put her through a scope. There are so many things that can go wrong.  

[cyclinglady]

Consult with a GI.  She might not have celiac or she might not.  Not everyone tests positive to the TTG (like me and other forum members).  But know that she is at risk of developing it at anytime in her life.  For example, my own daughter is tested every couple of years even if asymptomatic.  

http://www.cureceliacdisease.org/faq/are-raised-dgp-igg-levels-an-early-sign-of-celiac-disease/

 There is a small percentage (less than 10) that some celiacs test negative on all the blood tests, yet they still have celiac disease.  

The scope does seem nerve wracking, but it is not.  I think browsing through the kids section will put you at ease.  A firm diagnosis is important if she has celiac disease in terms of school support.  I just had my kid retested (no symptoms or odd biomarkers like anemia, which is how I presented) because it had been a few years and she is going off to university and will live in a dorm.  

This lab online has a nice chart.  It indicates too that if the DGP IgG is elevated, celiac disease is possible.  Usually the DGP antibodies develop or show first in kids under two because they are still developing antibodies.  But your daughter and me are much older than toddler!  The blood tests are good, but NOT perfect.  It is the reason biopsies are still required.  

https://labtestsonline.org/tests/celiac-disease-antibody-tests

[LostRiverSu]

I'm sorry, but I have one more question... Would the one "positive" result be considered a "weak positive"? 3 of the 4 tests were in the low range of normal. Only the DGP IgG was a little elevated: It was 18.2 and the top of the reference range was 14.9, so that's just slightly over. Could that be elevated simply because she has thyroid antibodies in her system already? Is "Weak positive" a thing? Thanks again!

[cyclinglady]

My diagnosing GI called my result a “weak” positive.  A few weeks later, my biopsies confirmed a Marsh Stage IIIB which is moderate to severe patches of villi destruction.  I did not have any GI symptoms at the time either.  I guess my body adapted.  Five years later, I had a repeat biopsy and my villi were healthy!  

The DGP is really specific to celiac disease.  The TTG could be raised by her thyroid, but I have  not seen the DGP as an indicator of any other Autoimmune disorder other than celiac disease.  

Jane Anderson, author of this article is a reliable source:

https://www.verywellhealth.com/celiac-disease-blood-tests-562694