Gliadin Ab IgA

[Marmee]

Hello,

I’m new to the forum and have a question about Gliadin Ab IgA.  If  the results are weak positive does that mean I have Celiac Disease?

[trents]

Welcome to the forum, Marmee!

One challenge in interpreting lab results is the variations found in terminology from lab to lab.

I think the test you are referring to is also called Deamidated gliadin peptide IGA. https://celiac.org/about-celiac-disease/screening-and-diagnosis/screening/

It is a secondary diagnostic test for celiac disease that is sometimes run in addition to the tTG-IGA, the latter being the most popular test run by docs because it combines good specificity with good sensitivity. And it is economical. The test you report in your post is not as specific for celiac disease, meaning a positive can be caused by other things, and is often run when what's called "total serum IGA" is low. In addition, your score is a low positive.

This certainly could mean you have celiac disease but it could also point to other medical conditions as mentioned in the link above.

Were you eating significant amounts of gluten in the weeks and months leading up to the blood draw? If you were not, then it would have the effect of sabotaging the testing with false negatives. Also, was there a test done for total serum IGA? Is the information you gave in your first post complete? Seems like there should be more.

Right now, it looks kind of inconclusive and you may be asked to have an endoscopy with biopsy done of the small bowel lining  to check for damage to the villi that line the small bowel. This is considered to be the hallmark of celiac disease and the biopsy is considered to be the gold standard diagnostic test.

[knitty kitty]

@Marmee,

A positive is a positive.   

Like being a little bit pregnant. 

😸  Welcome to the club.

You can double check with a genetic test.  Most Celiacs have HLA DQ 2 or 8, though there are more rare Celiac genes out there.  

You don't have to be eating gluten to get a genetic test.  Some people can't complete a gluten challenge if they've been gluten free for a short time.  The autoimmune response is much worse if gluten is reintroduced.  

[Marmee]

Thank you for the input. A little back story on my stomach issues.  I have always had stomach issues but it became progressively worse eight years ago when I had my gallbladder out.  I was sick all the time and went to my doctor a year later.  She ordered  tests to check for Celiac.

test results:

Tissue Transglutaminase Ab IgA / <2

IgA/ 374

Gliadin Ab IgA/ 24

Fecal Fat / increased

When the test came back she gave me referral to see a GI doctor.  He looked at my results and told me I have Celiac but they would have to do a scope to see how much damage.  He also told me to go gluten-free , which I did. I was off gluten for about 20 days. My scope came back with no abnormalities so he told me to stay off gluten because I had an allergy to it. 
Fast forward to the present. I have been off gluten for seven years. I’m having trouble with reflux etc. so I went to another GI doctor. He wants to check for  ulcers etc. I told him about my experience with the previous GI and he was shocked that he told me to go gluten free before my scope.  My new doctor wants to check for celiac  so I  went back to eating gluten. Needless to say I am sick. Nauseated, vomiting, fatigue, headaches and my face has also developed bumps. I’ve been back on gluten for 5 weeks and my scope is next week. I also have Rheumatoid Arthritis and I have bloodwork done every three months. My bloodwork is all out of wack and my liver enzymes are high. I have never had that before. It’s just so frustrating and I feel like the scope will be a waste of time considering the tests that were done seven years ago. 
 

 

[knitty kitty]

@Marmee,

I am so sorry you're going through this.  Lots of us have been misdiagnosed, misdirected, and mistreated by doctors ignorant of Celiac Disease.  My heart goes out to you.  

You're almost done with the gluten challenge, so stay strong.  You can make it through.  You will have a baseline endoscopy with which to compare future endoscopies if problems arise (heaven forbid).  

Make sure all testing (endoscopy and additional antibody blood tests) are done before going gluten free.  

I'm sure many of your symptoms will improve as soon as you're off gluten.  Others may improve further if nutritional deficiencies are addressed.  

Becoming low in certain nutrients can occur on the Gluten Free diet.  Since you've been gluten free for seven years, you should be checked for nutritional deficiencies as part of proper follow up care for people diagnosed with Celiac Disease.

Gallbladder dysfunction and reflux are conditions that happens in Thiamine Vitamin B 1 deficiency.  I had my gallbladder removed, and had reflux as well.  Thiamine deficiency diseases can get much worse, but supplementing with Thiamine easily improves things.  Thiamine helps with Rheumatoid arthritis and liver function.  Raised liver enzymes are a symptom of Thiamine deficiency.  (Ask for a Erythrocyte Transketolase test for Thiamine deficiency.  Blood tests are not accurate.)

Were you prescribed a PPI for your reflux?

[trents]

Elevated liver enzymes is what eventually led to my diagnosis of celiac disease. But it tool 13 years from when I first became aware of the elevated liver enzymes until  the time when I was diagnosed with celiac disease. My GP was clueless and I finally scheduled an appointment with a GI doc and he tested me right away for celiac disease. But by that time I had developed osteopenia and kyphosis of the spine and number of other food sensitivity issues.

[Marmee]

54 minutes ago, knitty kitty said:

@Marmee,

I am so sorry you're going through this.  Lots of us have been misdiagnosed, misdirected, and mistreated by doctors ignorant of Celiac Disease.  My heart goes out to you.  

You're almost done with the gluten challenge, so stay strong.  You can make it through.  You will have a baseline endoscopy with which to compare future endoscopies if problems arise (heaven forbid).  

Make sure all testing (endoscopy and additional antibody blood tests) are done before going gluten free.  

I'm sure many of your symptoms will improve as soon as you're off gluten.  Others may improve further if nutritional deficiencies are addressed.  

Becoming low in certain nutrients can occur on the Gluten Free diet.  Since you've been gluten free for seven years, you should be checked for nutritional deficiencies as part of proper follow up care for people diagnosed with Celiac Disease.

Gallbladder dysfunction and reflux are conditions that happens in Thiamine Vitamin B 1 deficiency.  I had my gallbladder removed, and had reflux as well.  Thiamine deficiency diseases can get much worse, but supplementing with Thiamine easily improves things.  Thiamine helps with Rheumatoid arthritis and liver function.  Raised liver enzymes are a symptom of Thiamine deficiency.  (Ask for a Erythrocyte Transketolase test for Thiamine deficiency.  Blood tests are not accurate.)

Were you prescribed a PPI for your reflux?

I will have to look into Thiamine. That never crossed my mind. I was prescribed  PPl but haven’t taken it yet. Thank you so much for your suggestions.  

[trents]

1 minute ago, Marmee said:

I will have to look into Thiamine. That never crossed my mind. I was prescribed  PPl but haven’t taken it yet. Thank you so much for your suggestions.  

Avoid long term PPI therapy if you possibly can. It raises gut PH which makes vitamin and mineral absorption less efficient and digestion in general. You may need to investigate other food intolerance/sensitivity issues as it is par for the course for celiacs to develop them. Also, research histamine intolerance/MCAS (Mast Cell Activation Syndrome) and SIBO (Small Intestine Bacterial Overgrowth), both of which are common in the celiac community.

[knitty kitty]

I agree with @trents.  

Do not take the PPI.  It can cause more inflammation.  

Reflux or Gerd is symptomatic of low stomach acid, hypochlorhydria.  Deficiency in Niacin Vitamin B3 can cause low stomach acid.  

My Gerd resolved after supplementing with Niacin.

There are eight B vitamins which all work together.  A B Complex usually contains all eight.  Talk to your doctor before starting supplementation, in case testing is offered.  Blood tests aren't really accurate measurements for vitamins because most vitamins work inside cells, not in the bloodstream.  Taking supplements before testing will reflect the vitamins you've taken.  

[Scott Adams]

This article might be helpful. It breaks down each type of test, and what a positive results means in terms of the probability that you might have celiac disease. One test that always needs to be done is the IgA Levels/Deficiency Test (often called "Total IGA") because some people are naturally IGA deficient, and if this is the case, then certain blood tests for celiac disease might be false-negative, and other types of tests need to be done to make an accurate diagnosis. The article includes the "Mayo Clinic Protocol," which is the best overall protocol for results to be ~98% accurate.

Quote

The DGP-IgA test is considered to have high sensitivity and specificity. In general, the DGP-IgA test has been reported to have a sensitivity ranging from 75% to 95% and a specificity ranging from 90% to 100%. The DGP tests have been found to have a sensitivity of around 85-95% and a specificity of around 95-98%.

 

 

[Marmee]

3 hours ago, Scott Adams said:

This article might be helpful. It breaks down each type of test, and what a positive results means in terms of the probability that you might have celiac disease. One test that always needs to be done is the IgA Levels/Deficiency Test (often called "Total IGA") because some people are naturally IGA deficient, and if this is the case, then certain blood tests for celiac disease might be false-negative, and other types of tests need to be done to make an accurate diagnosis. The article includes the "Mayo Clinic Protocol," which is the best overall protocol for results to be ~98% accurate.

 

 

The article was very informative. Thank you for posting it.