2 + and 2- on blood...

[Jzsnow]

Hi y’all. My 13 year old daughter had a celiac panel a few weeks ago. Her biopsy is today. 
 

Here are the blood results:

deamidated gliadin Abs, IgA 20 (weak +)

Deamidated gliadin Abs, IgG 2 (0-19 is neg)

T-transglutaminase tTG, IgA <2 (0-3 is neg)

t-transglutaminase tTG, IgG 8 (weak + is 5-8)

So what do y’all think? Why would you have 2 positives and 2 negatives?

symptoms: always constipated, stomach pain nightly, swollen lymph nodes in her stomach, anemic for not ferritin levels but rather iron saturation, and must nap after volleyball practice, the gym, etc.

thanks!!

 

[trents]

17 minutes ago, Jzsnow said:

Hi y’all. My 13 year old daughter had a celiac panel a few weeks ago. Her biopsy is today. 
 

Here are the blood results:

deamidated gliadin Abs, IgA 20 (weak +)

Deamidated gliadin Abs, IgG 2 (0-19 is neg)

T-transglutaminase tTG, IgA <2 (0-3 is neg)

t-transglutaminase tTG, IgG 8 (weak + is 5-8)

So what do y’all think? Why would you have 2 positives and 2 negatives?

symptoms: always constipated, stomach pain nightly, swollen lymph nodes in her stomach, anemic for not ferritin levels but rather iron saturation, and must nap after volleyball practice, the gym, etc.

thanks!!

 

Before I forget, I hope your daughter has not  been trying to eat gluten free since her blood tests were done. Doing so may have allowed healing of the small bowel villi and cloud the biopsy test results.

The centerpiece of the blood antibody labs is the tTG-IGA. It is the most specific for celiac disease and is positive. The other antibody tests are less specific for celiac disease and if they are positive it can point to other inflammatory diseases of the gut. Therefore, it is quite common for some of the antibody tests to be negative and some positive when someone has celiac disease. Do you have the result for total IGA count? If total IGA is low it depresses the individual IGA tests. Kudos to your doctor for running the full celiac antibody panel instead of just the tTG-IGA.

Keep us posted. Her symptoms scream of either celiac disease or non celiac gluten sensitivity and the blood work points to celiac disease. 

Edited July 26, 2021 by trents

[Jzsnow]

Oh no, we absolutely gluttoned her up prior to today. We basically had to force her to eat last night. Her stomach was hurting and she just didn’t want food anymore.

It’s is just confusing when there are 2 tTG and 2 deamidated yet she’s 1:1 for each. Makes almost zero sense to me.

8 minutes ago, trents said:

Before I forget, I hope your daughter has not  been trying to eat gluten free since her blood tests were done. Doing so may have allowed healing of the small bowel villi and cloud the biopsy test results.

The centerpiece of the blood antibody labs is the tTG-IGA. It is the most specific for celiac disease and is positive. It is quite common for some of the antibody tests to be negative and some positive when someone has celiac disease. Do you have the result for total IGA count? If total IGA is low it depresses the individual IGA tests. Kudos to your doctor for running the full celiac antibody panel instead of just the tTG-IGA.

Keep us posted. Her symptoms scream of either celiac disease or non celiac gluten sensitivity and the blood work points to celiac disease. 

You said the TTG-IGA is the most specific, but that was negative...it was <2.

[trents]

The biopsy is the gold standard of celiac disease diagnosis. Especially when the blood work is inconclusive. Yes, you are correct about my mistake with the TTG-IGA. My bad. I didn't look closely enough. It is also possible your daughter has non celiac gluten sensitivity which has most of the same symptoms as celiac disease but does not damage the small bowel villi.

If she has been off of gluten several weeks before the biopsy, one day of gluten cramming immediately before the biopsy will not do it. The guidelines are consumption of two slices of wheat bread daily (or the equivalent) for at least two weeks before the biopsy. Unfortunately, many docs fail to inform their patients about the need to be eating gluten regularly before testing.

[Scott Adams]

From the symptoms you describe and her two positive results, it does look like she may have celiac disease or non-celiac gluten sensitivity, and the treatment for either is the same, a gluten-free diet. The final confirmation would be the biopsy results, but even if that comes back negative, the true test would be if her symptoms go away on a gluten-free diet, and come back once gluten is added back.