Confusing results! Help

[Han]

I received these results been am unsure what they mean. Are these normal for a person with celiac? 
 

 

[trents]

I think you left something out of your post. Namely, the values themselves. We need the reference values as well to be able to know what normal range is for each test. Different labs used different reference values.

[Han]

Sorry! 

Immunoglobulin A-61L (reference-70-400mg/dL)

Gliadin Deamidated Ab,IgG- <11 (reference - <15.0 U/mL)

Gliadin Deamidated Ab,IgA - <12 (reference - <15.0 U/mL)

Endomysial IgA, IFA- Positive (no reference)

Transglutaminase Ab, IgA - <12 (reference - <15.0 U/mL)

[trents]

"Endomysial IgA antibody testing has a lower sensitivity than tTG IgA (positive predictive value = 79%; 95% CI, 71.0 to 85.5) and equivalent specificity. It is included in several diagnostic algorithms but is not considered a first-line test in any patient population." https://www.aafp.org/afp/2017/0601/p726.html

A very unusual test result when the Endomysial IgA is positive while the Transglutaminase (aka, tTG-IGA) is negative, since the tTG-IGA is considered to be the more sensitive test.

Had you already been on a gluten free diet prior to testing?

[Han]

Yes I’ve been on a gluten-free diet for about 6 months prior to this test. 

[trents]

Being on a gluten free diet for more than a week or two will likely invalidate the testing. That probably explains your odd results and so many negatives. If you want to get accurate test results you will need to be eating gluten daily for 6-8 weeks leading up to the test, consuming an amount of gluten equivalent to two slices of wheat bread daily.

[Scott Adams]

Yes, your doctor should have mentioned this to you, but if you have your original results it would be interesting to compare the two tests. This would likely show how well you've adhered to a gluten-free diet. 

 

[Jan Meindfak]

On 5/13/2021 at 3:13 AM, Han said:

Sorry! 

Immunoglobulin A-61L (reference-70-400mg/dL)

Gliadin Deamidated Ab,IgG- <11 (reference - <15.0 U/mL)

Gliadin Deamidated Ab,IgA - <12 (reference - <15.0 U/mL)

Endomysial IgA, IFA- Positive (no reference)

Transglutaminase Ab, IgA - <12 (reference - <15.0 U/mL)

Not only you should start eating some bread for some time before testing like others have already mentioned, but also I believe checking IgA class antibodies in your case is pointless since you're apparently IgA deficient. They should be redone in IgG. 

Please correct me if I'm wrong!