Trouble understanding bloodwork - Only Have High DGA IgG and High IGA Serum

[PrismagicMushroom]

Hi everyone! I know this question gets asked constantly, but I'm running into brick walls with my own google-fu and could use a slightly more knowledgeable eye.

I got a celiac bloodwork panel done recently (results below) and I'm struggling to figure out if this means I likely have celiac or not. Everything I find online just talks about the other factors I was tested for, and not the one I came back positive for.

My biopsy is on Tuesday but I won't get to discuss the results with my doc until June due to lack of appointments. He seemed to consider this more of a differential diagnosis step and doesn't sound like he actually thinks I have celiac...though it's possible I misread him.

Thanks for reading.

Labcorp Test Results:

                     Name                            |     Result          |     Typical Range

1. Deamidated Gliadin Abs, IgA    |    4 units          |      0-19 units
2. Deamidated Gliadin Abs, IgG    | [H]  29 units  |      0-19 units
3. t-Transglutaminase (tTG) IgA    |    <2 U/mL       |      0-3 U/mL
4. t-Transglutaminase (tTG) IgG    |   <2 U/mL        |      0-5 U/mL  
5. Endomysial Antibody IgA         |   Negative        |      Negative
6. Immunoglobulin A, Qn, Serum |  278 mg/dL     |      87-352

[knitty kitty]

@PrismagicMushroom,

Welcome to the club!  Looks like your DGP test is positive and you only need one positive test.  

Have you been eating gluten prior to the blood tests? 

 

Edited April 30, 2023 by knitty kitty
Typo correction

[PrismagicMushroom]

  On 4/30/2023 at 2:25 AM, knitty kitty said:

@PrismagicMushroom,

Welcome to the club!  Looks like your DGP test is positive and you only need one positive test.  

Have you been eating gluten prior to the blood tests? 

 

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Yes, I had never considered I might be celiac so I have never been gluten free. I have continued eating my normal gluten-full ever since the blood work so I could do the biopsy with accurate results.

[knitty kitty]

@PrismagicMushroom,

What prompted you to go to the doctor?  Maybe better said, what prompted the doctor to test for Celiac?

[PrismagicMushroom]

@knitty kitty Been seeing a rheumatologist for persistent joint pain, and its changed over the last year after a tick borne infection (that she caught on a hunch when other doctors missed it! She saved my life). Her best guesses for what's causing my chronic severe inflammation and moderate joint pain is that the rocky mtn spotted fever triggered either seronegative rheumatoid arthritis, or celiac. So she ran panels for both and sure enough, my RA came back completely negative but my celiac panel came back as I posted above. I got her to discuss with my gastro doc, who agreed to discuss the possibility of biopsy with me at my follow up visit from some other unrelated tests last week, and here we are. Those other tests (abdominal ultrasound of organs, and gastric emptying study) came back just fine. So we're running the biopsy.

[PrismagicMushroom]

@knitty kitty Been seeing a rheumatologist for persistent joint pain after a tick borne infection (that she caught on a hunch when other doctors missed it! She saved my life), but the pain has changed in the last couple months from the reactive arthritis I was used to, to a more holistic immune system response.  Her best guesses for what's causing my chronic severe inflammation, brain fog, and moderate joint pain/swelling is that the rocky mountain spotted fever triggered either seronegative rheumatoid arthritis, or celiac. So she ran panels for both and sure enough, my RA came back completely negative but my celiac panel came back as I posted above. I got her to discuss with my gastro doc, who agreed to discuss the possibility of biopsy with me at my follow up visit from some other unrelated tests last week, and here we are. Those other tests (abdominal ultrasound of organs, and gastric emptying study) came back just fine. So we're running the biopsy.

 

Edited for grammar

[knitty kitty]

@PrismagicMushroom,

Yes, Celiac Disease can be precipitated after an infection.  

During an infection, our bodies can run short on Vitamin B1, Thiamine.  High dose Thiamine can help recovery.  

Vitamin D deficiency can cause symptoms of arthritis.  

Celiac Disease damages the small intestine where vitamins and minerals are absorbed.  Supplementing with a B Complex, Vitamin D, magnesium and Thiamine can help with healing.

https://www.hormonesmatter.com/beyond-deficiency-thiamine-metabolic-stimulant/

[trents]

Kudos to your rheumatologist for running a celiac panel and a more complete one at that! Many docs will only order the tTG-IGA as it is the single best test for diagnosing celiac disease. It combines good sensitivity with good specificity and is around 98% accurate. However, for whatever reason, some people's immune response is atypical and they will throw a negative for the tTG-IGA even though they do have celiac disease. That is the value of running a more complete celiac panel as some of the other tests will catch what the tTG-IGA missed. However, with the exception of the EMA which is very specific for celiac disease, these other tests are not as specific for celiac disease and a positive for one of them may indicate another problem or some  transitory medical condition.

[Russ H]

Isolated IgG DGP antibodies are not very specific for coeliac disease. In people under the age of 18, has a positive predictive value (PPV) of about 3% The small study below estimates a PPV of between 2.3% and 51.8% in adults (the large uncertainty is due to the small size of the study).

https://celiacdiseasecenter.columbia.edu/wp-content/uploads/2018/12/Diagnostic-Yield-of-Isolated-Deamidated-Gliadin-Peptide-Antibody-Elevation-for-Celiac-Disease.pdf

[PrismagicMushroom]

  On 4/30/2023 at 11:40 AM, Russ H said:

Isolated IgG DGP antibodies are not very specific for coeliac disease. In people under the age of 18, has a positive predictive value (PPV) of about 3% The small study below estimates a PPV of between 2.3% and 51.8% in adults (the large uncertainty is due to the small size of the study).

https://celiacdiseasecenter.columbia.edu/wp-content/uploads/2018/12/Diagnostic-Yield-of-Isolated-Deamidated-Gliadin-Peptide-Antibody-Elevation-for-Celiac-Disease.pdf

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That makes sense, thank you for the info! I am turning 30 this year so the adult part is what applies to me, but still.