Iga Over 100? Normal Less Than 11

[azmom3]

My 10 year old just got his blood test results back and the nurse called and said his IgA was over 100 and it's supposed to be less than 11. She's new and didn't sound like she knew what she was talking about, couldn't answer any of my questions, etc. I haven't seen the tests yet to verify all the numbers. I can't remember which numbers mean what, but the allergist is sending us to the GI as they suspect celiac.

I suspected celiac months ago and requested a test then, but it came back negative. We were running blood tests for food allergies and I asked the allergist if we could add this to the list of things he was being tested for and he was all for it...good thing we checked it out again.

Our youngest son (27 months) had an endoscopy several weeks ago, (checking for both celiac and eosinophilic esophagitis (EE). The results showed that he had eosinophilic esophagitis, but no damaged villi. We were planning on doing the gluten-free diet anyways for our whole family regardless of what the results said, but his diagnosis temporarily put a hold on things as he has to be off all foods and was put on a special elemental formula for his sole source of nutrition. Taking care of him has consumed us lately. I finally went out last night though and picked up some tinkyada pasta and other naturally gluten-free stuff with the intention of starting up on this. Then I get the call this morning saying they suspect celiac. Due to the fact that his brother was diagnosed with EE, we are definitely going to wait now and do the endoscopy, so at the very least I can have peace of mind that he doesn't have this too. And if he does, we can get him on the road to recovery rather than go any longer not knowing what to do for him. I don't want to assume it's just celiac, when there could be something else.

Any help with the IgA numbers would be appreciated!

Thanks!

[Sophiekins]

If your son's IgA is over 100, this means that his immune system is working far too hard, which would imply that he has an auto-immune condition, one of the possibilities for this is celiac disease. False negatives on the test are about 3 in 100, so it is entirely possible that your son's first test was negative and the second positive; he may also have been immuno-suppressed when the first test was done. You have to be careful in ruling out celiac disease with a negative biopsy - reading celiac disease in a biopsy is an art, not a science and the result (particularly in toddlers) is dependent on the area biopsied and the experience of the tech reading the sample. By all means treat the EE first, but reconsider celiac disease if he fails to thrive.

Hope that helps.

[azmom3]

  Sophiekins said:

If your son's IgA is over 100, this means that his immune system is working far too hard, which would imply that he has an auto-immune condition, one of the possibilities for this is celiac disease. False negatives on the test are about 3 in 100, so it is entirely possible that your son's first test was negative and the second positive; he may also have been immuno-suppressed when the first test was done. You have to be careful in ruling out celiac disease with a negative biopsy - reading celiac disease in a biopsy is an art, not a science and the result (particularly in toddlers) is dependent on the area biopsied and the experience of the tech reading the sample. By all means treat the EE first, but reconsider celiac disease if he fails to thrive.

Hope that helps.

Thank you!

Any ideas what other conditions it could be? Do all auto-immune diseases cause you to have high IgA or just certain ones? I felt pretty sure it was celiac for the last several months, but I've been doing so much research that I'm driving myself (and everyone else) crazy diagnosing everyone with something!

And we will try the gluten-free diet regardless of the results, but I want to make sure I wait so I can have him checked for both celiac and EE at the same time. Thanks again!

[Guest Villanfam]

https://www.celiac.com/st_prod.html?p_prodid=58

Anti-Gliadin Antibodies:

Both IgA and IgG anti-gliadin antibodies (AGA) are detected in sera of patients with gluten sensitive enteropathy (celiac disease). IgG anti-gliadin antibodies are more sensitive but are less specific markers for disease compared with IgA class antibodies. IgA anti-gliadin antibodies are less sensitive but are more specific. In clinical trials, the IgA antibodies have a specificity of 97% but the sensitivity is only 71%. That means that, if a patient is IgA positive, there is a 97% probability that they have celiac disease. Conversely, if the patient is IgA negative, there is only a 71% probability that the patient is truly negative for celiac disease. Therefore, a positive result is a strong indication that the patient has the disease but a negative result does not necessarily mean that they don not have it. False positive results are rather uncommon but false negative results can occur. On the other hand, the IgG anti-gliadin antibodies are 91% specific and have an 87% sensitivity. This means that they will show positive results more readily but there is not as strong a correlation with celiac disease. It is less specific. Patients with other conditions but not afflicted with celiac disease will occasionally show positive results. IgG anti-gliadin antibodies are detectable in approximately 21% of patients with other gastrointestinal disorders. This test might yield false positive results but is less likely to yield false negative results.

A sensitive testing protocol includes testing for both IgA and IgG anti-gliadin antibodies since a significant portion of celiac patients (approx. 2-5%) are IgA deficient. This combined IgA and IgG anti-gliadin antibody assay has an overall sensitivity of 95% with a specificity of 90%. The type of test used to detect the anti-gliadin antibodies is called an ELISA. This is an acronym and it stands for Enzyme Linked Immuno-Sorbent Assay. "ELISA" is not a test in itself. It is a method of testing and it is a relatively simple test to perform. It involves putting a measured amount of diluted patient serum into the wells of a specially constructed and prepared plate and incubating it for a period of time with various chemicals. The end result is a color change, the intensity of which is dependent upon the concentration of anti-gliadin antibody (or other protein being measured) in the patient serum. The ability of this colored solution to absorb light at a particular wavelength can be measured on a laboratory instrument and mathematically compared with solutions that contain a known amount of anti-gliadin antibody to arrive at a number for the amount of antibody present. The sample can then be classified as negative, (0-20 units); weak positive, (21-30 units); or moderate to strong positive if greater than 30 units. The purpose of testing for anti-gliadin antibodies includes, in addition to diagnosis of gluten sensitive enteropathy, monitoring for compliance to a gluten free diet. IgA gliadin antibodies increase rapidly in response to gluten in the diet and decrease rapidly when gluten is absent from the diet. The IgA anti-gliadin antibodies can totally disappear in 2-6 months on a gluten free diet, so they are useful as a diet control. By contrast, IgG anti-gliadin antibodies need a long time, sometimes more than a year, to become negative. The reverse is also true. That is, a patient with celiac disease who has been on a gluten free diet and tests negative for IgA anti-gliadin antibodies, will show a rapid increase in antibody production when challenged by gluten in the diet. Approximately 90% of challenged patients will yield a positive IgA anti-gliadin result within 14-35 days after being challenged. The IgG antibodies are somewhat slower.