Need help interpreting test results...

[footer87]

I'm not sure I understand my 5 year old's bloodwork results.  We have been going at this for about 8 months - her first test was a weak positive ttg, negative ema.  Her second round of testing included the gliadin iga and igg tests, as well as ttg and ema.  All results were negative across the board.  Her last test in December came back with another low positive ttg, but higher than original and positive ema.  My questions are:

1. What do the ratios mean in the EMA results?  Her ratio was 1:20.

2. For the Gliadin tests, I have read that those are more specific for children...is this true?  

3. Is this for sure Celiac and should I put her through a scope?

Thank you for any input!  

[RMJ]

In the EMA test the patient’s serum is diluted and added to a microscope slide with a certain type of tissue. If there are a lot of antibodies in the serum it can be diluted a lot and still give a positive result.  For example, a 1:160 dilution would mean more antibodies in the sample than a 1:20 dilution.

Has your daughter continued to eat gluten all through this testing?

[footer87]

1 hour ago, RMJ said:

In the EMA test the patient’s serum is diluted and added to a microscope slide with a certain type of tissue. If there are a lot of antibodies in the serum it can be diluted a lot and still give a positive result.  For example, a 1:160 dilution would mean more antibodies in the sample than a 1:20 dilution.

Has your daughter continued to eat gluten all through this testing?

Yes, and for her second test she was probably eating the highest amount of gluten being that we were on summer break (more junk food, eating out at restaurants, etc.).  I'm just so confused at the wavering results. 

[Scott Adams]

Hopefully she was eating at least 2 slices of wheat bread's worth of gluten daily for 6-8 weeks before the blood tests, otherwise they cold produce false negative results, or weak positive instead of strong positive. Also, children should have this blood test done: DGP-IgA and DGP-IgG (Deamidated Gliadin Peptide).

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.