Learning about IGA-Deamidated Glutamine results

[Jennybean15]

Hi-

i just underwent celiac testing and I am trying to understand the notes in the lab results. I have been tested before (2 years ago) for IGA/M/etc. with normal ranges. 
 

“GLIADIN PEPTIDE ANTIBODY IGA

Normal range: 0.00 - 4.99 FLU

Value

<0.72

(NOTE) Low IgA antibody levels suspected.”

I feel ignorant asking this (multi-part!) question, but is that just a “note” doctor puts so that the full panel is covered by insurance? I know that in IGA insufficient people it’s different (I had entire reflex panel done)

Also,If the range is normal 0-4.9 then how can you be low?

I am just trying to understand if I should have my full immunoglobulin panel done again, and would love clarification. Thank you!

[trents]

Welcome to the forum community, @Jennybean15!

From your narrative, it is evident that your physician suspects your are IGA deficient. However, there is no indication from the information you posted that he/she actually ran a test for "total IGA" to test for IGA deficiency. Was a test for total IGA run at a different time?

The one test you do mention in your post is the DGP-IGA, a reflexively ordered test when IGA deficiency is present. Your DGP-IGA is negative. By any chance, had you already embarked on a gluten free diet or at least significantly cut back on gluten consumption when blood draws were taken?

Was there also a DGP-IGG test run?

Here is an article giving overviews of tests that can be run when diagnosing celiac disease: 

 

[mickirose]

I'm in the UK so we may do things differently, but my take on it would be that it looks like your IgA antibody is on the low-normal side so the doctor is, quite rightly, suggesting the result might suggest total IgA production is low. If it's low, then the 'real' result might be a lot higher in reality. They should really have done an IgA total test at the same time, but they rarely do. It's nice to see a doctor note it though - although not suggest a follow up IgA Total test! Hope that helps. 

[Jennybean15]

Hi- thanks to you both. I’m glad you read it the same way I did, though I wrote it in an unclear way😊. To me it looks like the laboratory doctor testing my blood thinks my IGA is low (.72< ). ( If the normal range is O-4.9 , it doesn’t seem logical to me, but that’s besides the point)

I had my total IGA tested twice, in 2019/2022, the ranges were normal. To me it seems it should be re-tested!

Flash forward two years, I still have seronegative RA symptoms but negative blood work (with regard to inflammatory markers ) & the rheumatologist decided celiac could be a possibility (should’ve been done as part of my initial work up , it looks like from my research here!)

I did have all three tests  (DGP-IGG also , and TTG as well). 
 

it seems that I could be gluten sensitive without being celiac, so if there is anything else you have encountered as far as diagnostic tools , it would help to know. I am going to begin a gluten-free diet anyway, as I think it’s better for my overall health!

I appreciate any input and have a lovely day. 

 

 

 

[Scott Adams]

If you've had your total IGA levels done twice in the past and they were normal, it isn't likely that will change. It's my non-doctor understanding that you are either total IGA deficient or you are not, and this will not change over your lifetime.

[trents]

Welcome to the forum community, @Jennybean15!

From your narrative, it is evident that your physician suspects your are IGA deficient. However, there is no indication from the information you posted that he/she actually ran a test for "total IGA" to test for IGA deficiency. Was a test for total IGA run at a different time?

The one test you do mention in your post is the DGP-IGA, a reflexively ordered test when IGA deficiency is present. Your DGP-IGA is negative. By any chance, had you already embarked on a gluten free diet or at least significantly cut back on gluten consumption when blood draws were taken?

Was there also a DGP-IGG test run?

Here is an article giving overviews of tests that can be run when diagnosing celiac disease: 

Yes. If you have celiac disease-like symptoms but all testing is negative then the logical conclusion is NCGS (Non Celiac Gluten Sensitivity) and the antidote for both is the same at the end of the day anyway.

Edited April 30, 2024 by trents

[mickirose]

15 hours ago, Scott Adams said:

If you've had your total IGA levels done twice in the past and they were normal, it isn't likely that will change. It's my non-doctor understanding that you are either total IGA deficient or you are not, and this will not change over your lifetime.

As a clinician, I don't agree with that. I think there are some people who are indeed genetically low IgA (and that's what mainstream medicine sees as 'low IgA'), but I see levels of immunoglobulins fluctuate all the time depending on how the immune system is doing, if infections are present etc etc, so always worth checking IMHO. Certainly SIgA, the mucosal IgA goes up and down all the time, esp if a person is stressed, getting poor sleep etc. 

[Scott Adams]

I agree that IgA level may fluctuate to some degree, but for those who are genetically deficient it will always be low, and in this case any IgA celiac screening will likely be incorrect (usually false negative). I want to emphasize that this test should always be included in a celiac panel but is often omitted, which can skew results and lead to missed diagnoses.