Help with antibody questions

[TriticumToxicum]

Hello everyone!

I have been tested for celiac in 2014/2015 and was all negative in biopsy and blood test. I am positive for DQ8 and DQ7, so my doctor told me to come back for retesting if I feel like something is up.

I have had some really stressful weeks and things escalated, so I wanted to go back on a gluten-free diet ASAP. I went to a different doctor this time and asked for testing an she unfortunately only got two things tested:

Gliadin IgA 16 EliA/ml (normal <7)

Gliadin IgG <1 EliA/ml (normal <7)

What do I make of this? I am going back Thursday to ask for the ttg-test and to ask if this is the "old" gliadin-test or the deaminated Gliadin. Does anyone know if the unit EliA/ml mean it is the deaminated test? As far as I know, the EliA points at ELISA and I am not sure if there is an ELISA for the old version, since it isn't used anymore. 

Thankful for any explanations and comments!

 

 

 

[TriticumToxicum]

Forgot to add:

the reason for testing in 2014/2015 was that I felt awesome on 3-month-gluten-free diet. I did go back on gluten prior to blood tests and biopsy, but I am not sure for how long. I think it was 10-12 weeks. 

My blood results in 2015 were as follows:

ttg IgA Celikey 0,3 U/ml (normal <7)

ttg IgG <0,6 U/ml (normal <7)

DGP IgA 1,6 U/ml (normal <7)

DGP IgG <0,4 U/ml (normal <7)

[Scott Adams]

It looks like you have one blood test positive for celiac disease, and more about that is here:

"IgG anti-gliadin antibodies are more sensitive but are less specific markers for disease compared with IgA class antibodies. IgA anti-gliadin antibodies are less sensitive but are more specific. In clinical trials, the IgA antibodies have a specificity of 97% but the sensitivity is only 71%. That means that, if a patient is IgA positive, there is a 97% probability that they have celiac disease. "

 The normal protocol for celiac disease blood tests is for you to eat the equivalent of 2 slices of wheat bread per day for 6-8 weeks before the tests, and 2 weeks before a biopsy.

Since you already have a positive blood test, and you report feeling much better on a gluten-free diet, perhaps you should just go gluten-free? Of course discuss this with your doctor, but it sounds like that might be the outcome no matter what the tests indicate.

[TriticumToxicum]

Thank you so much for your reply! The text you linked here is really informative! 

You're right, I think I will definitely go gluten-free (at least for a while), but I would like to know for sure, because 1. I already am fructose intolerant and it has been a constant battle with some relatives, who think I just need to be special and constantly feel the need to comment on my eating habits (I really don't know why it even matters to them if I eat fruit cake or not, but ok), so it would be much easier to have a rock-solid diagnosis if I need to also cut out gluten. And 2. it would be much easier to not have to be so strict and careful with trace amounts since there is 4 people in my house and I am not sure if it's possible to ban gluten from the house for everyone.

I will ask for the ttg-test tomorrow and go from there. Although, if it is true that a positive IgA is 97% specific for celiac, then I should probably get used to the idea of being a celiac?! 

[TriticumToxicum]

I am posting an update for anyone who stumbles into this thread with a similar question:

I spoke with my doctor today and the positive test I have is deaminated Gliadin-Antibodies, so that makes the test a lot more specific.

They think I have celiac disease, but the IgG is negative, because I might just beginning to react to gluten. I am supposed to eat gluten-free from now on and they want to test me again in 6 months to see if all the antibodies are down. They don't want to test the ttg-antibodies, because those might also still be negative.

I would have liked to at least see ttg IgA to be a little more sure about the diagnosis, but oh well. 🤷🏼‍♀️

I have an appointment with a specialist two weeks from today, so maybe they will help me with that.

[Scott Adams]

Thanks for the update! This article will be helpful: