Need help interpreting test results...

[footer87]

I need some insight to my 4 year old daughters situation.  We just got her bloodwork back for the stomach pain she has had for about 8 weeks now.  All blood work is normal, except for her Celiac panel.  But I'm so confused with her test results.  Her TTG/IGA came back slightly elevated at 19, but then her EMA was negative and Immunoglobulin was in normal range.  She has no other symptoms, except for the stomachache that has no rhyme or reason to it.  Could it be Celiacs?  Or could it just be an intolerance?  Thanks in advance. 

[trents]

Yes, she certainly could have celiac disease. It would have been helpful to have IGP and DGP antibody tests run as well, especially since she is a young child. Young children's immune system commonly respond atypically to the tTG-IGA test but will throw positives for IGP and DGP testing. The fact that she did throw a positive for the tTG-IGA test is solid evidence IMO that she has celiac disease. Do not cut back on her gluten if you intend to pursue further testing at this time.

 

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

Edited April 20, 2023 by trents

[Scott Adams]

Can you also share the reference ranges for the tests, with her scores? Different labs use different scales.

[footer87]

Yes, for her TTG/IGA, the range is <15.0 U/mL antibody not detected, >15.0 U/mL antibody detected.  She is at 19.0.  Her Immunoglobulin A is 129 with the range for normal being 22-140 mg/dL.  EMA test is negative. 

[Scott Adams]

This is definitely a positive blood test for celiac disease, and I agree with @trents that children should also be given the DPG tests as well, because their immune symptoms are not fully developed. The article below has more info, and includes this:

Quote

tTG-IgA (tissue transglutaminase IgA) blood test for celiac disease - This test measures the levels of IgA antibodies to tissue transglutaminase, an enzyme that is involved in the immune response to gluten in those who have celiac disease. The test is estimated to have a sensitivity of approximately 90%, which means that it correctly identifies 90% of people with celiac disease. It also has a high specificity of around 95%, which means that it correctly identifies 95% of people who do not have celiac disease.

 The normal next step would be to have an endoscopy done, and to do any further testing for celiac disease she would need to continue to eat gluten daily until all tests are completed.

Another approach might be to just have her go gluten-free for a few months to see if her stomach aches go away, but down the road this could lead to questions about whether the diet is necessary for her. 

[LCAnacortes]

When my daughter was little she was getting tummy aches with milk and then later diarrhea too.  She naturally stayed away from milk products and I didn't force them on her. She drank water with meals.  Later she had a D attack right after eating something with whipped cream so then we knew for sure - she was Lactose Intolerant.  Meanwhile - I learned last May that several first cousins and their offspring were having problems and some were diagnosed with celiac. I have many of the symptoms so went gluten free without testing.  Once I eliminated gluten - I still had issues and sure enough I was lactose intolerant too.  If your daughter has celiac then that means one of her parents has celiac too.  I hope she feels better soon. I am so sorry you are going through this but you have a village of support here. 

[trents]

37 minutes ago, LCAnacortes said:

When my daughter was little she was getting tummy aches with milk and then later diarrhea too.  She naturally stayed away from milk products and I didn't force them on her. She drank water with meals.  Later she had a D attack right after eating something with whipped cream so then we knew for sure - she was Lactose Intolerant.  Meanwhile - I learned last May that several first cousins and their offspring were having problems and some were diagnosed with celiac. I have many of the symptoms so went gluten free without testing.  Once I eliminated gluten - I still had issues and sure enough I was lactose intolerant too.  If your daughter has celiac then that means one of her parents has celiac too.  I hope she feels better soon. I am so sorry you are going through this but you have a village of support here. 

Correction in order here. It means one or both of her parents have the genes that make for the potential to develop celiac disease.