14 Month Old W/+gliadin Igg

[TBLKWL]

I HAVE A QUESTION THAT I AM HOPING SOMEONE CAN ANSWER. I HAVE A 14 MONTH OLD LITTLE GIRL WHO HAS HAD DIARRHEA FOR ABOUT 3-4 MONTHS. OUR DR DECIDED TO DO THE CELIAC PANEL AFTER I ASKED ABOUT IT AND NOW IT HAS COME BACK WITH THE GLIADIN ANTIBODY IGG AS HIGH. WE ARE GOING TO GET IN TO SEE THE GI DR AND GO FROM THERE. OUR DR REALLY DIDNT KNOW ANY THING ABOUT CELIAC AND I HAVE BEEN A NURSE FOR 2 YRS AND HAD NEVER HEARD ABOUT IT UNTIL A FRIEND MENTIONED IT. I HAVE NOW IDEA WHAT TO DO AND SINCE THE BLOOD TEST IS POSITIVE DOES THAT MEAN SHE DOES HAVE IT? FOR NOW WE ARE TRYING TO BE GLUTEN FREE, BUT WITH DAYCARE AND A 4Y/O BROTHER IT IS HARD TO KEEP IT FROM HER.

ANY INPUT WOULD BE GREAT. I JUST FEEL LOST NOW.

THANKS

[GFBetsy]

First, welcome. There's a lot of help to be found here.

Second: If you want the GI doc to do a biopsy (for a "firm" diagnosis) your daughter will have to be eating gluten consistently for about 3 months beforehand. (If she's only been off for a week or so, you might be okay just putting her back on right now, especially if she's been getting into it accidentally.

Third: The first little while is the most overwhelming part. Sit down and make a list of all of the foods that ARE gluten free . .. fruits, veggies, meats, etc. Having a "What I CAN give her" list makes dealing with celiac a lot easier.

Sorry I can't spend more time answering . . . I've already been on the computer for hours, and my kids are starting to destroy the house . . . not to mention begging for lunch (gluten free, of course!)

Stick around. More people will show up to help you out.

[chrissy]

the antigliadin IgG doesn't necessarily mean she has celiac. what tests did they run besides that one?

[TBLKWL]

the antigliadin IgG doesn't necessarily mean she has celiac. what tests did they run besides that one?

ENDOMYSIAL ANTIBODY-NEGATIVE

GLIADIN IGA- NEG

AND SOME TRANSGLUTIMINASE TISSUE IGA THAT IS STILL PENDING.

[Guest Villanfam]

" Antigliadin antibodies

The antigliadin antibodies IgG and IgA recognize a small piece of the gluten

protein called gliadin. These antibodies became available during the late

1970

[TBLKWL]

" Antigliadin antibodies

The antigliadin antibodies IgG and IgA recognize a small piece of the gluten

protein called gliadin. These antibodies became available during the late

1970

[Guest nini]

after all testing is done, even if it isn't Celiac (yet) it might still be gluten intolerance, so AFTER the testing is done if you don't have an answer, try the diet and see if it helps.

[Guest Villanfam]

Just curious if the tTG tests came back yet?

[TBLKWL]

Just curious if the tTG tests came back yet?

It came back 3 pt high. So they are calling it negative. I have made an appt with the GI Dr for Jan 3rd and they told me to keep her on gluten until they see her. We went 3 days gluten free and it was great, no diarrhea and she was actually happy after the second day.

Thanks for asking. We are hoping for gluten intolerant.

[chrissy]

she's above the cut-off point---and they are calling it negative???? so what is the point of having a normal range in the test if every doc interprets it their own way? this is just MY opinion, but i would think that any positive value above the cut-off point in a child that young would be considered postitive because young children with celiac often don't produce any Ttg antibodies until they are a little older.

[Guest Villanfam]

I'm not sure if someone with only gluten intolerences (not celiac disease) would have 3 points high for the tTG antibodies !

You can find this info here: https://www.celiac.com/st_prod.html?p_prodid=58

Endomysial Antibodies:

IgA class anti-endomysial antibodies (AEA) are very specific, occurring only in celiac disease and DH. These antibodies are found in approximately 80% of patients with DH and in essentially 100% of patients with active celiac disease. IgA endomysial antibodies are more sensitive and specific than gliadin antibodies for diagnosis of celiac disease. Antibody titers (dilutions) are found to parallel morphological changes in the jejunum and can also be used to reflect compliance with gluten-free diets. Titers decrease or become negative in patients on gluten free diets and reappear upon gluten challenge.

The test for anti-endomysial antibodies is more subjective and more complicated for the lab to perform than the anti-gliadin assays. It involves serially diluting some of the patients serum, that is, diluting it by 1/2 then 1/4, 1/8, 1/16, etc. and putting these dilutions on a glass slide that has some sort of tissue affixed to it. The slide is then processed with various solutions and examined under a fluorescent microscope to determine if any of that serum binds to any of the proteins in the tissue. If so, then that patient is confirmed as having antibodies to that particular protein. This method of testing is called an IFA or sometimes IIFA. It stands for Indirect Immuno-Fluorescent Assay. The selection of which tissue slide to use is determined by what specific protein, hence which antibody, you are specifically looking for. Endomysial antibodies react with the endomysium, which is a sheath of reticular fibrils that surround each muscle fiber. Therefore, to detect endomysial antibodies, you would want to use a tissue substrate that contains a lot of muscle tissue. The substrate used most often for this assay is distal sections of the esophagus. These are very thinly sliced and fixed to the slide. They contain muscle fibers and not much else so there is a lot of endomysium available to react with the anti-endomysial antibodies.

Reading this test involves viewing the reacted slides with a fluorescent microscope to make the determination. This requires a highly skilled and trained eye and, of necessity, is somewhat subjective. You are looking for a green fluorescence in the endomysium covering the muscle fibers. The test is reported as the "titer" or final dilution in which the fluorescence can still clearly be seen. As you can imagine, this is very subjective. There are no standardized values and it is up to the judgement of the particular technician what the endpoint titer is.

Recently, (1998) the endomysial antigen targeted by the anti-endomysial antibodies was identified as the protein cross-linking enzyme known as tissue transglutaminase (tTG). This has enabled the production of an antigen specific ELISA assay incorporating tTG as a reliable and objective alternative to the traditional and subjective Immunofluorescence based assays. In clinical trials, the correlation with the endomysial IFA assay has been shown to be close to 100%. This is a test that has been very well received in the professional community. It is an ELISA, like the anti-gliadin antibody test and, as such, is not subject to interpretation like the IFA. That is the greatest advantage to this new test! With this or any ELISA, the response is measured on an instrument that calculates the amount of light of a particular wavelength that is absorbed by the solution and prints out a numerical result. There is no chance of human error skewing the results because there is no judgement call involved. The ELISA plate, regardless of what you are testing for, is processed with at least three control sera (sometimes as many as eight) in addition to the unknown sample being tested. There is a negative serum and at least two positive sera containing different levels of the antibody being tested. There are specific requirements for the absorption levels of these three controls. That is, each of them has a minimum or maximum (or both) number that must be seen by the instrument in order for it to be a valid test. If there is any variance from these expected numbers, it is an indication that something went wrong and the test results are discarded and the test repeated. There is therefore no way the technician could report inaccurate results, (assuming they diluted the sample correctly). Either the test was valid, and you can rely upon the accuracy of the result, or the test is invalid, and the entire result discarded. If any error was made during the processing of the ELISA plate, it would result in the control sera numbers being out of range and the entire test result would be thrown out.

In summary, the tTG ELISA is measuring the same thing that the endomysial IFA is measuring but with a method that is more sensitive and specific and not subject to interpretation.

[azmom3]

I HAVE A QUESTION THAT I AM HOPING SOMEONE CAN ANSWER. I HAVE A 14 MONTH OLD LITTLE GIRL WHO HAS HAD DIARRHEA FOR ABOUT 3-4 MONTHS. OUR DR DECIDED TO DO THE CELIAC PANEL AFTER I ASKED ABOUT IT AND NOW IT HAS COME BACK WITH THE GLIADIN ANTIBODY IGG AS HIGH. WE ARE GOING TO GET IN TO SEE THE GI DR AND GO FROM THERE. OUR DR REALLY DIDNT KNOW ANY THING ABOUT CELIAC AND I HAVE BEEN A NURSE FOR 2 YRS AND HAD NEVER HEARD ABOUT IT UNTIL A FRIEND MENTIONED IT. I HAVE NOW IDEA WHAT TO DO AND SINCE THE BLOOD TEST IS POSITIVE DOES THAT MEAN SHE DOES HAVE IT? FOR NOW WE ARE TRYING TO BE GLUTEN FREE, BUT WITH DAYCARE AND A 4Y/O BROTHER IT IS HARD TO KEEP IT FROM HER.

ANY INPUT WOULD BE GREAT. I JUST FEEL LOST NOW.

THANKS

Please also read up on eosinophilic esophagitis or other eosinophilic disorders. My son's high IgG was what led them to take biopsies and diagnose him with this after over a year of problems.