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Positive/ elevated test results: tTg-IgA, DGP-IgA, and DGP-IGG, plus have HLA DQ2 gene. But negative for Endomysial antibody scr. Could this be false positive for celiac disease?

Ecann74
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Go to solution Solved by trents,

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Ecann74 Newbie
Ecann74
Posted

Have some symptoms for celiac disease and doctor ordered celiac panel from quest labs. 

RESULTS:

Gliadin deamidated AB IGG  85.8 U/mL  HIGH       (≥15.0 U/mL Antibody detected)

Gliadin deamidated AB IGA  18.6 U/mL  HIGH     (≥15.0 U/mL Antibody detected) 

Tissue Transglutaminase AB IgA   18.4 U/mL  HIGH      (≥15.0 U/mL Antibody detected)

Tissue Transglutaminase AB IgG   <1.0 U/mL  Normal  (<15.0 U/mL Antibody not detected)

Endomysial antibody scr IGA  NEGATIVE

IgA (Immunoglobulin A)   217 mg/dL  Normal   (Range 47-310)

Have one celiac disease variant in the HLA-DQA1 gene  HLA-DQ2.5  result from 23andme.

So it looks like the numbers are just slightly high, and I'm wondering if anyone else had results like this and was confirmed positive with biopsy?

Or because of the NEG Endomysial result these could be a false positive for celiac disease?

 

Any help is appreciated.

 

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  • Solution
trents Grand Master
trents
Posted
  • Solution

A false positive is possible but the EGA is not as sensitive a test as the tTG-IGA. It is normal with celiac disease to have some positive and some negative blood antibody test scores. And it is possible that you will show negative on the biopsy despite some positive antibody scores. Depends on a lot of things, one being how long since onset. A negative biopsy could indicate recent onset and not enough time for damage to show up in the SB villous lining. Or, you may be in transition between NCGS and celiac disease. 

knitty kitty Grand Master
knitty kitty
Posted

Welcome to the forum, @Ecann74!

@trents is right.  You don't have to check every box to Bingo for Celiac Disease.  The high IgA, IgG and positive genes are sufficient for a Celiac diagnosis.

In fact, this study found that negative Endomysial antibodies might be related to long lasting untreated coeliac disease. 

Endomysial antibody‐negative coeliac disease: clinical characteristics and intestinal autoantibody deposits

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1856451/

Hope this helps!  Keep us posted on your progress!

Ecann74 Newbie
Ecann74
Posted
  • Author

Thanks to you both for the info. It was very helpful! I have appointment in March with a GI.  Hopefully she'll schedule me for an upper endoscopy and go from there.

Scott Adams Grand Master
Scott Adams
Posted

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.

 

 

Ecann74 Newbie
Ecann74
Posted
  • Author

TY for article it was helpful.

Andrew Dankanich Newbie
Andrew Dankanich
Posted

In regards to your lab results...Schedule an Upper GI endoscopy with biopsies of the duodenum to rule out celiac disease.  

 

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