Test result confusion high Immunoglobin A

[Alibee]

My insurance didn’t cover testing but my results came back as normal but high for Immunoglobin A. I added the notes below. I have gluten rashes on my hands that go away when I take gluten out of my diet. What do these results mean? They didn’t give me much info and I’d love some help. 
thank you. 

Tissue Transglutaminase Ab IgA

NORMAL

Your Result

<1.0

Immunoglobin A

Current Result Aa HIGH 

342 mg/dL

Desired Range

47-310

mg/dL

 

[trents]

Welcome to the forum, @Alibee!

The Tissue Transglutaminase Ab IgA (aka, tTG-IGA) is a blood antibody test designed to detect the antibodies produced  by celiac disease. It is the most popular single test ordered by physicians for this purpose but there are several others that could have been ordered. This test was negative in your case.

The Immunoglobin A (aka, "total IGA") is not a test for celiac disease per se but is used to check for IGA deficiency. If the person being tested for celiac disease is IGA deficient, this may produce false negatives in the tTG-IGA test. You are not IGA deficient so this is not an issue in your case.

Some people who actually have celiac disease are seronegative, meaning the usual antibodies associated with celiac disease inflammation of the small bowel lining are not being produced by the immune system and don't show up in the blood tests. 

The rash on your hands you speak of, can you describe the appearance of the rash? Does it have little pustules in the center of the pimples? There is a skin manifestation of celiac disease known as dermatitis herpetiformis (Dermatitis Herpetiformis) and it has a characteristic appearance with pustules in the center of the bumps. It sounds like you may be aware of dermatitis herpetiformis.

Do you have other symptoms that correlate with celiac disease? What motivated you or what led to you being tested for celiac disease?

Edited December 17, 2024 by trents

[Alibee]

The rash on my hands is the little blisters or  dermatitisherpetiformi you are referencing. They itch like crazy and no doctor has ever been able to get them to go away. When I remove gluten from my diet they go away. I decided to do the test for that reason. It’s really my only symptom but my sister has celiac disease and the same hand rash. her doctor recommended I get tested. 

[trents]

When you had the blood draw done for the antibody testing, had you already been practicing a gluten free diet? If so, that would also sabotage the results of the tTG-IGA.

[Alibee]

I was eating gluten at the time it was done. I do not eat commercially processed food and we make it all from scratch so I wonder if that might cause an issue. 

[trents]

I would not think abstaining from commercially processed food would have any effect on dermatitis herpetiformis. What can help with dermatitis herpetiformis is reducing iodine in your diet and, of course, you must completely abstain from gluten. 

Many who suffer from dermatitis herpetiformis cannot find relief until they get on a med called Dapsone. It seems to be pretty effective but stresses the liver. So, anyone taking it must have their liver enzymes monitored regularly.

By the way, celiac disease is the only know cause for dermatitis herpetiformis. Has your rash been officially diagnosed as dermatitis herpetiformis? It can be a challenge to find a dermatologist who knows how to properly biopsy dermatitis herpetiformis when seeking a diagnosis.

Edited December 17, 2024 by trents

[Alibee]

I haven’t been diagnosed formally. My doctor always called it eczema but over the years I have figured out it isn’t. 
I’ll do some research on iodine. Thanks for that info.