Please help me figure out these results

[concernedmomx4]

My daughter is 16 and is so sick. She bloats to the point of being in pain, nausea, lightheadedness. She doesn't have a dairy/lactose issue so now they have done the celiac cascade. The results look good to me???  But I am confused by the interpretation provided. It is the weekend so I won't know anything until next week. They also found low carbon dioxide levels in her blood so unsure if that correlates. 

DEAMIDATED GLIADIN PEPTIDE (DGP) AB, IGg

Normal value: 0.00 - 4.99 FLU

Value

<0.56

INTERPRETIVE INFORMATION: Deamidated Gliadin Peptide (DGP) Ab, IgG In individuals with low or deficient IgA, testing for tissue transglutaminase (tTG) and deamidated Gliadin (DGP) antibodies of the IgG isotype is performed. Positive tTG and/or DGP IgG antibody results indicate celiac disease

 

Value

<0.82

 

INTERPRETIVE INFORMATION: Tissue Transglutaminase Ab, IgG In individuals with low or deficient IgA, testing for tissue transglutaminase (tTG) and deamidated Gliadin (DGP) antibodies of the IgG isotype is performed. Positive tTG and/or DGP IgG antibody

 

DEAMIDATED GLIADIN PEPTIDE (DGP) AB, IGA

View trends

Normal value: 0.00 - 4.99 FLU

Value

<0.72

Low IgA antibody levels suspected. Tissue transglutaminase, IgG and deamidated gliadin peptide, IgG tests to follow. INTERPRETIVE INFORMATION: Deamidated Gliadin Peptide (DGP) Ab, IgA A positive deamidated gliadin (DGP) IgA antibody result is associated with celiac disease but is not to be used as an initial screening test due to its low specificity

TISSUE TRANSGLUTAMINASE (TTG) AB, IGA

View trends

Normal value: 0.00 - 4.99 FLU

Value

<1.02

Tissue transglutaminase, IgA antibody below lower limit of detection. Deamidated gliadin peptide, IgA test to follow. INTERPRETIVE INFORMATION: Tissue Transglutaminase (tTG) Antibody, IgA Presence of the tissue transglutaminase (tTG) IgA antibody is associated with gluten-sensitive enteropathies such as celiac disease and dermatitis herpetiformis. Individuals with positive results should be confirmed with small intestinal biopsy to establish celiac disease diagnosis. tTG IgA antibody concentrations greater than 50 FLU exhibits higher correlation with results of duodenal biopsies consistent with celiac disease. For antibody concentrations greater than or equal to 5 FLU but less than 10 FLU, additional testing for endomysial (EMA) IgA concentrations may improve the positive predictive value for disease. A decrease in tTG IgA antibody concentration after initiation of a gluten-free diet may indicate a response to therapy.

[trents]

Welcome to the forum, @concernedmomx4!

This sentence from the printout results you posted may be key here: "Low IgA antibody levels suspected." This is a reference to what we call "total IGA". Total IGA is not an test for celiac disease per se but a measure of the entire immune system IGA load. If total IGA is low, it will suppress individual IGA scores and can, therefore, produce false negatives. What should have been done and what now needs to be done is to have her total IGA measured.

The most important test in the several that were run for your daughter is the TISSUE TRANSGLUTAMINASE (TTG) AB, IGA or "tTG-IGA" for short. It is the most common celiac antibody test ordered by doctors and combines good specificity for celiac disease with good sensitivity. The DGP, IGP tests are helpful but not as specific. They are particularly helpful in pediatric cases since their immunes systems are not fully developed and may respond atypically to the tTG-IGA. 

Another factor that can skew celiac antibody test scores downward toward the negative range is if the patient has been already cutting back on gluten, ether consciously or subconsciously. And this may be not selective, just part of eating much less in general. Since your daughter has been having so much pain and bloating when eating I wonder if this is an issue.

[concernedmomx4]

So as her results stand it is negative for celiac correst?

[trents]

At this point, yes, they are negative. However, there are caveats as I mentioned. And there is also the possibility that she has NCGS (Non Celiac Gluten Sensitivity) for which there is no testing available yet. NCGS and celiac disease share many of the same symptoms and NCGS is 10x more common. Some experts believe NCGS can be a precursor to celiac disease. The antidote for both is the same: a strict gluten-free diet for a lifetime. Other food intolerances are also very common in conjunction with both celiac disease and NCGS. Chief among them are dairy (either lactose or casein is the problem), soy, eggs, oats and corn. So, you might look at some of these other foods as co-culprits. 

[Amgutierrez]

Would it be normal for 3 people to have the same exact results? I came across this forum because I noticed me and my mom have the exact same results as this post, like every single test we both have the same results 

[trents]

33 minutes ago, Amgutierrez said:

Would it be normal for 3 people to have the same exact results? I came across this forum because I noticed me and my mom have the exact same results as this post, like every single test we both have the same results 

This could happen if these numbers represent the lower limits of the detection technology. In this case, if celiac disease-like symptoms persist I would suspect NCGS since they share similar symptoms but there is no test for NCGS at this point in time.