False Positive?

[HannahLaF]

My daughter has a very low BMI paired with incredibly high mood swings, poor weight gain, and constipation. She got norovirus and struggled to make a comeback from that. One week post noro, her dr decided to run some routine tests since she still had a very minimal appetite and had not gained any weight back. One of those tests came back positive her Gliadin Ab (IGG) came back at 59. A different dr, (not her pediatrician) told me this could be a false positive since she was tested after a GI bug. Has anyone had experience with this? we cut gluten out as soon as we got the results. We have seen improvement in slow weight gain, moods, and she has a much better appetite! This dr recommended we put her back on gluten and retest her in 6 weeks. Does anyone have thoughts on that? 

[trents]

Welcome to the forum, HannahLaF!

How old is your daughter? Children often do not respond the same to celiac antibody testing as adults do because of immature immune systems. Children who actually do have celiac disease will often produce negatives for the tTG-IGA test which is the most common antibody test for celiac disease that doctors order. It is to your physician's credit that he/she ordered additional antibody testing.

The gliadiin AB IGG is not as specific for celiac disease as is the tTG-IGA or the EMA so the physician who felt that the postive could be due to Noro may have a point.

It is true that if you want to pursue further testing your daughter would need to go back on regular amounts of gluten. Has there been any discussion of second tier testing through an endoscopy/biopsy of the small bowel lining? That is the normal progression of testing for confirmation. Celiac disease damages the small bowel lining (the "villi"). A positive biopsy is considered the gold standard for diagnosing celiac disease but it is also true that children with celiac disease often will not show damage because their bodies are so resilient.

Sorry, I know my response does not constitute a clear path answer for you but you are in sort of a "tweener" spot with this right now.

[knitty kitty]

@HannahLaF,

The doctor saw your daughter's improvement after the virus and gluten free.  Yes, some severe norovirus infections in young children can cause damage to the intestines.  

A gluten challenge for six weeks is necessary in order to test for antigliadin antibodies again.  If your daughter's antibodies are high again, it's likely Celiac and not the norovirus.  (Not diagnosing.) 

You may want to ask the doctor about nutritional supplements.  Your daughter may be depleted of vitamins and minerals since she was so sick.  Mood swings, loss of appetite, and constipation are early symptoms of thiamine (vitamin B1) and magnesium deficiency. 

 Keep us posted on your progress!

Hope you both feel better!  

P.S.  drinking green tea helps with digestive problems...

Therapeutic effectiveness of green tea leaf extract on clinical symptoms in children suffering viral gastroenteritis: A randomized clinical trial

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9580527/?report=reader

Edited April 25, 2023 by knitty kitty
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[HannahLaF]

8 hours ago, trents said:

Welcome to the forum, HannahLaF!

How old is your daughter? Children often do not respond the same to celiac antibody testing as adults do because of immature immune systems. Children who actually do have celiac disease will often produce negatives for the tTG-IGA test which is the most common antibody test for celiac disease that doctors order. It is to your physician's credit that he/she ordered additional antibody testing.

The gliadiin AB IGG is not as specific for celiac disease as is the tTG-IGA or the EMA so the physician who felt that the postive could be due to Noro may have a point.

It is true that if you want to pursue further testing your daughter would need to go back on regular amounts of gluten. Has there been any discussion of second tier testing through an endoscopy/biopsy of the small bowel lining? That is the normal progression of testing for confirmation. Celiac disease damages the small bowel lining (the "villi"). A positive biopsy is considered the gold standard for diagnosing celiac disease but it is also true that children with celiac disease often will not show damage because their bodies are so resilient.

Sorry, I know my response does not constitute a clear path answer for you but you are in sort of a "tweener" spot with this right now.

She is 3.5 thank you this is helpful information! 

[Scott Adams]

12 hours ago, HannahLaF said:

My daughter has a very low BMI paired with incredibly high mood swings, poor weight gain, and constipation. She got norovirus and struggled to make a comeback from that. One week post noro, her dr decided to run some routine tests since she still had a very minimal appetite and had not gained any weight back. One of those tests came back positive her Gliadin Ab (IGG) came back at 59. A different dr, (not her pediatrician) told me this could be a false positive since she was tested after a GI bug. Has anyone had experience with this? we cut gluten out as soon as we got the results. We have seen improvement in slow weight gain, moods, and she has a much better appetite! This dr recommended we put her back on gluten and retest her in 6 weeks. Does anyone have thoughts on that? 

That test does have a higher false positive rate, and it's too bad they did not do a full celiac blood panel that includes DPG and tTG tests. I would ask for those tests and she would need to keep eating gluten until all tests are done. At this point it looks like she may be have non-celiac gluten sensitivity, and the only way to rule out celiac disease would be further tests: