help in interperating test results as ref has changed

[David G]

The lab (ARUP Laboratories)that my Dr.  is using has changed the tests reference's and I'm confused, I'm trying to compare the results of my 15yr child to the results of a year ago I wonder if anyone can help me thanks.

in 2023 the results were as follows

TISSUE TRANSGLUTAMINASE AB, IGA    Normal range: 0 - 3 U/mL  6

GLIADIN PEPTIDE ANTIBODY IGA Normal range: 0 - 19 Units   2

GLIADIN PEPTIDE ANTIBODY IGG Normal range: 0 - 19 Units  2

Now in 2024 The Results are

TISSUE TRANSGLUTAMINASE AB, IGA  Normal range: 0.00 - 4.99 FLU  15.4

GLIADIN PEPTIDE ANTIBODY IGA  Normal range: 0.00 - 4.99 FLU    <0.72

GLIADIN PEPTIDE ANTIBODY IGG Normal range: 0.00 - 4.99 FLU   0.85

ENDOMYSIAL ANTIBODY IGA   Normal value: <1:10      <1:10

Does it mean that inflammation is worse drastically moderately or not at all 

Thanks

[trents]

Welcome to the forum community, @David G!

I don't know that you can draw any conclusions one way or the other from this data. In either case, the numbers do not indicate a high degree of inflammation IMO. It does appear your son may still be getting some gluten contamination. When he was originally diagnosed, was there an endoscopy/biopsy done? If so, what degree of damage to the villous lining of the small bowel was reported? Was it assigned a Marsh scale value? 

I would focus on ratcheting down your efforts to see that your son is eating gluten free and get the antibody tests run again in another year by the same lab that ran them this last time. 

Is he still symptomatic? If a biopsy was done at diagnosis you should request another one at about the two year mark to check for healing. It often takes that long or longer for significant rebound of the villous lining after going gluten free.

In the meantime, let me offer this article to help spot possible sources of continuing gluten contamination that you may be unaware of. Eating lower gluten is easy to achieve. Eating gluten free is much more challenging and there can be a considerable education curve to eliminate the hold out sources of gluten contamination. Eating out is the number one threat to truly gluten free eating as there is so much likelihood of cross contamination back in the kitchen in how food is prepared and handled.

 

[Scott Adams]

It looks like the first tTg-IgA test was 2x the cutoff for celiac disease, and the second test was 3x the cutoff, so one might conclude that gluten is getting into his diet somehow, as this level normally goes down over time when someone with celiac disease is 100% gluten-free. In teenagers cheating on the diet can be common, as I found out with my daughter, and eating out at restaurants is a very common source of contamination.