Is this celiac?

[Greek4eva323]

Hi I have recently been diagnosed with Celiac after having months of stool consistency and frequency issues and an upset stomach. The following was my results. Would you agree with a Celiac diagnosis? 

I have both genes for Celiac disease. My endoscopy biopsy showed mild intraepithelial lymphocytosis with preservation of the villlous architecture. my celiac blood panel had my t-transglutaminase (tTG)IgG positive at a 6. My Immunoglobulin A QN Serum was positive at a 366. 

 

My GI says it's celiac and to start a gluten-free diet. I have been on it for 3 weeks and am still having stomach and bowel issues. 

 

[trents]

You have used some terminology that is unfamiliar to me.

"preservation of the villlous architecture" Does this mean there was no villous atrophy?

"Immunoglobulin A QN Serum". Not sure what this is but it sounds like it might be referring to total IGA.

"tTG-IgG" was positive at 6". What is the reference range?

Did the physician run a tTG-IGA? That is considered the single best test for celiac antibodies. Yet, you do not list that in our results.

https://celiac.org/about-celiac-disease/screening-and-diagnosis/screening/

You may only think you are eating gluten free. It's much more difficult than most people think. Studies show that most who claim to be eating gluten free are actually practicing lower gluten eating. This primer may help: 

And three weeks might not be enough to see much improvement.

Edited May 19, 2022 by trents

[Greek4eva323]

5 minutes ago, trents said:

You have used some terminology that is unfamiliar to me.

"preservation of the villlous architecture" Does this mean there was no villous atrophy?

"Immunoglobulin A QN Serum". Not sure what this is but it sounds like it might be referring to total IGA.

"tTG-IgG" was positive at 6". What is the reference range?

Did the physician run a tTG-IGA? That is considered the single best test for celiac antibodies. Yet, you do not list that in our results.

https://celiac.org/about-celiac-disease/screening-and-diagnosis/screening/

You may only think you are eating gluten free. It's much more difficult than most people think. Studies show that most who claim to be eating gluten free are actually practicing lower gluten eating. This primer may help: 

And three weeks might not be enough to see much improvement.

Hi yes, it means there was no villous atrophy. 

 

The tTG reference range said 0-5 was Normal. 6 was a weak positive. 

 

My ttg-iga did not get flagged. 

[Greek4eva323]

Just now, Greek4eva323 said:

Hi yes, it means there was no villous atrophy. 

 

The tTG reference range said 0-5 was Normal. 6 was a weak positive. 

The Immunoglobulin A QN Serum from what I read online is it protects against infections of the mucous membranes lining the mouth, airways, and digestive tract. If they are high it could be a sign of an autoimmune disease, etc. 

Just now, Greek4eva323 said:

 

My ttg-iga did not get flagged. 

 

[trents]

Were you IGA deficient (low total IgA)? Just wondering why the physician ordered the tTG-IgG? Normally, that is run when total IGA is low since total IGA will suppress the individual IGA values.

[Greek4eva323]

 

I tried to copy and paste my celiac panel results below.  I am not sure which is the total IGA. 

 

Deamidated Gliadin Abs, IgA01 7 units 0-19
 Negative 0 - 19
 Weak Positive 20 - 30
 Moderate to Strong Positive >30
Deamidated Gliadin Abs, IgG01 2 units 0-19
 Negative 0 - 19
 Weak Positive 20 - 30
 Moderate to Strong Positive >30
t-Transglutaminase (tTG) IgA01 <2 U/mL 0-3
 Negative 0 - 3
 Weak Positive 4 - 10
 Positive >10
 Tissue Transglutaminase (tTG) has been identified
 as the endomysial antigen. Studies have demonstr-
 ated that endomysial IgA antibodies have over 99%
 specificity for gluten sensitive enteropathy.
t-Transglutaminase (tTG)
IgG01 6 High U/mL 0-5
 Negative 0 - 5
 Weak Positive 6 - 9
 Positive >9
Endomysial Antibody IgA01 Negative Negative
Immunoglobulin A, Qn,
Serum01 366 High Immunoglobulin A, Qn,

Serum01 366

[Greek4eva323]

t-Transglutaminase (tTG) IgA

Current Result:

<2

 

Negative 0 - 3
Weak Positive 4 - 10
Positive >10
.

[trents]

The tTG-IGG is less accurate (less specific for celiac disease) than the tTG-IGA is my understanding. The fact that you have no villous atrophy really is the key here as that is considered the gold standard for diagnosing celiac disease. Sometimes, however, we get people who are tested while in the early stages of celiac disease who have negative biopsies. If I were you I'd be investigating things like IBS and SIBO. 

 

Serum01 366 High Immunoglobulin A, Qn,

Serum01 366

https://www.webmd.com/a-to-z-guides/immunoglobulin-test#:~:text=If your immunoglobulin level is,arthritis%2C lupus%2C or celiac disease

If your immunoglobulin level is high, it might be caused by:

Allergies

Chronic infections

An autoimmune disorder that makes your immune system overreact, such as rheumatoid arthritis, lupus, or celiac disease

Liver disease

Inflammatory bowel disease

Cancer, such as multiple myeloma, lymphoma, or leukemia

 

I would advise going back to your doctor and ask some questions about that one. I don't think you can yet rule out celiac disease but there are other possibilities that should be investigated. 

Edited May 19, 2022 by trents

[Scott Adams]

I also want to add that around 10x more people have non-celiac gluten sensitivity, and there currently isn't a test for it. Since you have unexplained symptoms, and one positive blood test for celiac disease, you may still want to try a gluten-free diet for a few months to see if they go away. Just be sure that your doctor doesn't have any future tests planned for celiac disease before doing so, as this could lead to false-negative results.