TISSUE TRANSGLUTAMINASE AB, IGA is high and GLIADIN (DEAMIDATED) AB (IGG, IGA) - low - negative

[Bandmom]

My son follows a very strict Gluten free diet for the past 2 years and do not understand how his Ttg IGA can be at 43.7 but the Gliadin Iga at 1.2 and IGG 2.2 which is considered normal and negative.  Liver panel was normal.  I am at a lost of how to get this number down.

[plumbago]

I would like to see the exact name of the test you refer to as "gliadin IgA and gliadin IgG" before commenting more. We would also need to see the references ranges for every test you reference.

As for what you refer to as raised Ttg Iga, I think that might indicate short-term immune response, indicating ingestion of gluten 2-4 weeks preceding the test. But seeing the reference (normal) ranges may help.

I am no expert, though.

Plumbago

[Bandmom]

57 minutes ago, plumbago said:

I would like to see the exact name of the test you refer to as "gliadin IgA and gliadin IgG" before commenting more. We would also need to see the references ranges for every test you reference.

As for what you refer to as raised Ttg Iga, I think that might indicate short-term immune response, indicating ingestion of gluten 2-4 weeks preceding the test. But seeing the reference (normal) ranges may help.

I am no expert, though.

Plumbago

Here is the exact test name with reference.

GLIADIN (DEAMIDATED) AB (IGA) - 1.4 results

GLIADIN (DEAMIDATED) AB (IGG) - 2.2 result

U/mL 

See Note 1

Value Interpretation

<15.0 Antibody not detected

> or = 15.0 Antibody detected

 

For the Ttg reference: 

Value Interpretation

<15.0 Antibody not detected

> or = 15.0 Antibody detected

 

Again what is difficult is not knowing what was ingested as everything we have is gluten-free in the house and we dont eat out.  Although he has never had a biopsy done.  They just declared Celiac based on bloodwork.

[Scott Adams]

Can I ask how old your son is? I ask this because I dealt with a situation a few years back where my daughter, who I thought was 100% gluten-free and ok with her diet, started having symptoms again. It turned out that after she started high school she would cave in to peer pressure, or feel like she wanted to fit in, and would eat the pizza, hamburger, etc., when hanging out with her friends. It took a while for her to get through this stage and back to a true gluten-free diet. Younger kids can have issues like this as well, especially during lunch time at school where food might be shared.

[Bandmom]

56 minutes ago, Scott Adams said:

Can I ask how old your son is? I ask this because I dealt with a situation a few years back where my daughter, who I thought was 100% gluten-free and ok with her diet, started having symptoms again. It turned out that after she started high school she would cave in to peer pressure, or feel like she wanted to fit in, and would eat the pizza, hamburger, etc., when hanging out with her friends. It took a while for her to get through this stage and back to a true gluten-free diet. Younger kids can have issues like this as well, especially during lunch time at school where food might be shared.

My son is 16 and is he has been really carefully as he has other food allergies which makes being Celiac even harder.   His food allergies reactions are way worse than having gluten.  

[Scott Adams]

Does he include milk/dairy in his diet? There have been studies which have linked elevated tTg with dairy in some people:

 

[Bandmom]

1 hour ago, Scott Adams said:

Does he include milk/dairy in his diet? There have been studies which have linked elevated tTg with dairy in some people:

 

Yes he does drink milk and Ice cream that is Gluten Free but not dairy free.  I hope i dont have to take that away too.  Although he has not had any reactions or any issues with Milk.

[RMJ]

How high was his Ttg IgA when he was diagnosed?  I.e., is it at least coming down?

(Note: can only compare results if they were run by the same lab).

[Bandmom]

44 minutes ago, RMJ said:

How high was his Ttg IgA when he was diagnosed?  I.e., is it at least coming down?

(Note: can only compare results if they were run by the same lab).

Original diagnose was >100 so it is down from original diagnose, but seems to be stuck at the 43 range.

[Scott Adams]

It seems strange that it would not go lower if he's strictly gluten-free, but if he has an issue with casein/cow's milk that is keeping those antibodies high, then the best way to find out would be to eliminate dairy for a month or two and get re-tested.

Just in case, this article has some detailed information on how to be 100% gluten-free, so it may be helpful (be sure to also read the comments section.):

 

 

[Bandmom]

19 hours ago, Scott Adams said:

It seems strange that it would not go lower if he's strictly gluten-free, but if he has an issue with casein/cow's milk that is keeping those antibodies high, then the best way to find out would be to eliminate dairy for a month or two and get re-tested.

Just in case, this article has some detailed information on how to be 100% gluten-free, so it may be helpful (be sure to also read the comments section.):

I truly appreciate all the information provided.  I wish he would have a reaction to eating gluten as this would be way easier to pin point what it is but he is asymptomatic.

[RMJ]

I sympathize, I’m also asymptomatic. Took me six years to get my deamidated gliadin peptide IgA into the normal range.

[Bandmom]

The only test performed on my son is only blood work to diagnose him with Celiac Disease.  Is this the new standard now or should a Biopsy be performed as well as follow up? Just curious if i should request for biopsy testing as well even though dr never ordered it.

[Scott Adams]

In the Europe the new protocol for making a celiac disease diagnosis in children is if their tTG-IgA (tissue transglutaminase IgA) levels are 10 times or above the positive level for celiac disease.

According to the latest research, if the blood test results are at certain high levels that range between 5-10 times the reference range for a positive celiac disease diagnosis, it may not be necessary to confirm the results using an endoscopy/biopsy:

• Blood Test Alone Can Diagnose Celiac Disease in Most Children and Adults
• TGA-IgA at or Above Five Times Normal Limit in Kids Indicates Celiac Disease in Nearly All Cases
• No More Biopsies to Diagnose Celiac Disease in Children!

 

[BriGuy]

Hi. My daughter (11) has the same issue and was wondering if you figured anything out.  The only idea I am coming across is cow's milk protein sensitivity (or possibly some other cross-reactive food. Did your son eliminate dairy? Or get any kind of IGA food panel test?

[GardeningForHealth]

I believe this is called "Refractory Celiac Disease." It seems that doctors treat it like it's irritable bowel disease (IDB):

https://pubmed.ncbi.nlm.nih.gov/32654085/