Would you ask for further testing?

[CorrieP]

I appreciate your help in deciding the next steps. My 19 year old son was just tested for celiac and these are his results:

IgA 70mg/dL   (standard range 68-408mg/dL)

tTg, IgA <2 U/mL  (standard range 0-3U/mL)

 

Although the IgA isn't technically deficient, is it still low enough to cause an inaccurately low tTg measurement?

He is also low in some other tests I am concerned about as a possible indication of malabsorption. Iron 56 ug/dL (45-182 range), alkaline phosphatase 73 U/L (62-369 range), B-12 253 pg/mL (180-914 range).  His symptoms are fatigue, acne, hair loss, mild nausea, and mild jaundice that the doctor is blaming on dehydration. His albumin, direct bilirubin, and creatinine are all mildly elevated. I am also suspicious that his creatine supplementation contributed to some of these issues, 

My daughter has been diagnosed with celiac, and I am presuming myself as celiac but have been off gluten too long to want to get appropriate testing. Lots of years of eczema, gall bladder issues, vitamin deficiencies that all went away when I gave up gluten. I also have one copy of the of the HLA-DQB1 variant. 

 

Do you think I should ask for additional celiac tests? If so which ones? Thank you so much!

[trents]

15 minutes ago, CorrieP said:

I appreciate your help in deciding the next steps. My 19 year old son was just tested for celiac and these are his results:

IgA 70mg/dL   (standard range 68-408mg/dL)

tTg, IgA <2 U/mL  (standard range 0-3U/mL)

 

Although the IgA isn't technically deficient, is it still low enough to cause an inaccurately low tTg measurement?

He is also low in some other tests I am concerned about as a possible indication of malabsorption. Iron 56 ug/dL (45-182 range), alkaline phosphatase 73 U/L (62-369 range), B-12 253 pg/mL (180-914 range).  His symptoms are fatigue, acne, hair loss, mild nausea, and mild jaundice that the doctor is blaming on dehydration. His albumin, direct bilirubin, and creatinine are all mildly elevated. I am also suspicious that his creatine supplementation contributed to some of these issues, 

My daughter has been diagnosed with celiac, and I am presuming myself as celiac but have been off gluten too long to want to get appropriate testing. Lots of years of eczema, gall bladder issues, vitamin deficiencies that all went away when I gave up gluten. I also have one copy of the of the HLA-DQB1 variant. 

 

Do you think I should ask for additional celiac tests? If so which ones? Thank you so much!

I would ask for additional celiac antibody testing for your son which would include EMA, Deamidated gliadin peptide (DGP IgA and IgG). It is also possible he has NCGS (Non Celiac Gluten Sensitivity) which some experts believe can be a precursor to celiac disease.

Edited April 19, 2023 by trents

[Scott Adams]

It's too bad they did not do more blood tests, but please have a look at this article and I agree that the DPG test would be helpful, and perhaps the EMA-IgA (endomysial antibodies IgA), but this test is more expensive:

 

[CorrieP]

3 hours ago, trents said:

I would ask for additional celiac antibody testing for your son which would include EMA, Deamidated gliadin peptide (DGP IgA and IgG). It is also possible he has NCGS (Non Celiac Gluten Sensitivity) which some experts believe can be a precursor to celiac disease.

Thank you! Does that IgA seem problematically low compared to what else you see on here?

2 hours ago, Scott Adams said:

It's too bad they did not do more blood tests, but please have a look at this article and I agree that the DPG test would be helpful, and perhaps the EMA-IgA (endomysial antibodies IgA), but this test is more expensive:

 

I appreciate it! Hopefully he is willing to order additional tests for us. 

[trents]

1 hour ago, CorrieP said:

Thank you! Does that IgA seem problematically low compared to what else you see on here?

I appreciate it! Hopefully he is willing to order additional tests for us. 

The total IGA is technically with normal range but at the very low end of normal. It is a potential problem.