Test Results...what Do They Mean?

[azmom3]

The nurse told me our son's IgA was over 100. I picked up the report and it's actually the IgG that's over 100. Here are the numbers. What do you think?

IgE 522 - reference range 0-85

Immunoglobulins quantitative

IgG 1021 - reference range 821-1835

IgA 47 - reference range 64-246

IgM 54 - reference range 46-368

Gliadin Antibody Panel

Gliadin Ab IgA <3 - reference range - neg: <11

Gliadin Ab IgG >100- reference range - positive: >17

Tissue Transgluten antibody, IgA

(tTG) Ab, IgA <3 reference range - negative <5

[tarnalberry]

The nurse told me our son's IgA was over 100. I picked up the report and it's actually the IgG that's over 100. Here are the numbers. What do you think?

IgE 522 - reference range 0-85

Immunoglobulins quantitative

IgG 1021 - reference range 821-1835

IgA 47 - reference range 64-246

IgM 54 - reference range 46-368

Gliadin Antibody Panel

Gliadin Ab IgA <3 - reference range - neg: <11

Gliadin Ab IgG >100- reference range - positive: >17

1. Which IgE is that first test of? Whatever it is, it looks like he's got a pretty high, classic allergic response to it.

2. The quantitative IgA I am assuming to be a total serum IgA, in which case, he's IgA deficient.

3. Because he's IgA deficient, a negative anti-gliadin IgA can't tell you anything. He normally doesn't produce enough IgA, so trying to measure that which is anti-gliadin specific won't help.

4. His anti-gliadin IgG is high - quite high - so I'd say that he's reacting to gliadin, and chances are, given how celiac tends to test out, other glutens like it. Unless you are going forward with a biopsy, it's time to go gluten free.

[azmom3]

1. Which IgE is that first test of? Whatever it is, it looks like he's got a pretty high, classic allergic response to it.

2. The quantitative IgA I am assuming to be a total serum IgA, in which case, he's IgA deficient.

3. Because he's IgA deficient, a negative anti-gliadin IgA can't tell you anything. He normally doesn't produce enough IgA, so trying to measure that which is anti-gliadin specific won't help.

4. His anti-gliadin IgG is high - quite high - so I'd say that he's reacting to gliadin, and chances are, given how celiac tends to test out, other glutens like it. Unless you are going forward with a biopsy, it's time to go gluten free.

I'm not sure what the first IgE is for...that's all it says....it is below the foods he was allergic to so not sure if it has to do with that or not. He showed very mild, class 1 and class 2 allergies to wheat, corn, soy, peanut, and almond. This is his second blood test for celiac in about 3 months. The first one was negative but his IgA was a little low then, too; however, the dr. did not feel that it was low enough to officially say "IgA deficient and test null and void." I had a second opinion by our allergist who we completely trust and he felt the same way. Not sure if this time is lower than last time or now. We havent' been able to meet with the dr. yet, but I was begging for the nurse to just give me the info ahead of time. We re-ran the test because we KNOW something is not right, but just can't figure out what. We are meeting with our GI dr in a few weeks and will go the biopsies route as we will also be looking for EOS disorders, since our youngest was just diagnosed with EE. I am all for a gluten-free diet after that. I just can't stand the waiting and am hoping to get as much feedback on these numbers as possible. The thing that worries me is that they look very similar, but a lot higher, to our other son's results. I'm thinking EE again, but curious to see if celiacs have similar numbers too.

[Ursa Major]

You do know that EE can be caused by celiac disease, right?

[azmom3]

You do know that EE can be caused by celiac disease, right?

CAn you explain this to me or give me some links that explain the connection as I have been unable to find anything showing this. I'm not saying it's NOT connected either...I would just like something to have the confidence that it is and/or be able to bring to my doctors. Our allergist is phenomenal. We like him and trust him and I would feel very comfortable bringing any info into him. We will be doing the gluten-free thing regardless, so that I'm sure will be proof in itself, but I also realize it can take time to see results, so if there's info you have now, I'd appreciate it. Thanks!

[chrissy]

azmom---how old is your son? i agree that your son does not look like he is IgA deficient---just a little low. my son is IgA deficient and his total IgA serum levels are extremely low---like 6 on one scale, 7 on another---depending on the reference ranges. raised IgG levels may or may not be significant. i think following through with more testing is smart on your part.

[azmom3]

azmom---how old is your son? i agree that your son does not look like he is IgA deficient---just a little low. my son is IgA deficient and his total IgA serum levels are extremely low---like 6 on one scale, 7 on another---depending on the reference ranges. raised IgG levels may or may not be significant. i think following through with more testing is smart on your part.

He's 10 1/2. What you said about low IgA is exactly how our dr's described it...said it would be closer to o.

[Ursa Major]

CAn you explain this to me or give me some links that explain the connection as I have been unable to find anything showing this. I'm not saying it's NOT connected either...I would just like something to have the confidence that it is and/or be able to bring to my doctors. Our allergist is phenomenal. We like him and trust him and I would feel very comfortable bringing any info into him. We will be doing the gluten-free thing regardless, so that I'm sure will be proof in itself, but I also realize it can take time to see results, so if there's info you have now, I'd appreciate it. Thanks!

It appears that EE is the result of a food allergy. It is caused most often by dairy, but can be caused by wheat as well. I remember reading an article a while ago that made a clear connection to celiac disease, but can't find it right now.

Open Original Shared Link

Eosinophilic esophagitis

* Eosinophilic esophagitis (EE) can occur at any age. In infants and young children, EE presents with symptoms similar to those of GERD but fails to respond to conventional acid blockade therapy. Dysphagia and food impaction can occur in older children and adolescents. Eosinophilic esophagitis is often seen in patients with atopy who have asthma, eczema, or chronic rhinitis or in those who have a family history of atopic disease. Endoscopy may reveal a ringed appearance or linear furrows. Standard biopsy samples show severe eosinophilic infiltration with more than 15-20 eosinophils per high-magnification microscopic field being necessary for diagnosis. In contrast to GERD, eosinophilic esophagitis involves the mucosa, submucosa, and, possibly, the muscularis. Although multiple food antigens (eg, eggs, nuts, beef, wheat, fish, shellfish, corn, soy) can induce eosinophilic esophagitis, cow's milk protein is the most common precipitant.

Open Original Shared Link

Eosinophils are thought to migrate to the esophagus in response to foods that trigger an allergic response. The most common foods reported are milk, egg, soy, corn, wheat, beef, chicken, potato, oats, peanuts, turkey, barley, pork, rice, green beans, apples, pineapple, tree nuts and seafood.

[azmom3]

It appears that EE is the result of a food allergy. It is caused most often by dairy, but can be caused by wheat as well. I remember reading an article a while ago that made a clear connection to celiac disease, but can't find it right now.

Open Original Shared Link

Open Original Shared Link

Thanks Ursula!

What I don't understand though is that it's not just food allergy. It can be from environmental allergies as well. Plus, from what I understand, you can have non-allergy foods trigger your EE and allergic foods not trigger it.

What we've been told is to start on the elemental formula only for a minimum of 6 weeks to give the esophagus time to heal, then rescope. If there are still eosinophils present, we have to either go formula only for a longer period of time or look at environmental things that may be triggering it. If no eosinophils are present, we begin re-introducing foods at a very slow pace...I believe it's 4 at a time, starting from least likely to trigger and going up the line that way (and at no time including any foods that have already showed to be allergic...extensive food allergy testing is done to immediately eliminate these foods). The four foods are the only foods you are allowed until your next scope so you can see if they were triggers or not. I have read story after story of people having their EOS triggered by foods that they never showed or felt an allergic reaction to prior to that. Also, other people, several years down the line, who tried re-introducing mild allergy foods back in, and finding out they do not trigger the EOS.

I don't doubt that they're are probably people who have both, but I'm just not sold (yet?) that EE is BECAUSE of celiac. I realize celiacs often times have other allergies/intolerances/autoimmune disorders. I also know that people with EOS disorders often have lots of allergies. I think too little is known about EOS disorders right now though to say one way or another. The leading research is being done in Cincinatti. There's also another eosinophilic center at CHOP (Children's Hospital of Philadelphia). I've been trying to read up as much as possible, but I'm still far from an expert on the subject.

[JenKuz]

Thanks Ursula!

What I don't understand though is that it's not just food allergy. It can be from environmental allergies as well. Plus, from what I understand, you can have non-allergy foods trigger your EE and allergic foods not trigger it.

What we've been told is to start on the elemental formula only for a minimum of 6 weeks to give the esophagus time to heal, then rescope. If there are still eosinophils present, we have to either go formula only for a longer period of time or look at environmental things that may be triggering it. If no eosinophils are present, we begin re-introducing foods at a very slow pace...I believe it's 4 at a time, starting from least likely to trigger and going up the line that way (and at no time including any foods that have already showed to be allergic...extensive food allergy testing is done to immediately eliminate these foods). The four foods are the only foods you are allowed until your next scope so you can see if they were triggers or not. I have read story after story of people having their EOS triggered by foods that they never showed or felt an allergic reaction to prior to that. Also, other people, several years down the line, who tried re-introducing mild allergy foods back in, and finding out they do not trigger the EOS.

I don't doubt that they're are probably people who have both, but I'm just not sold (yet?) that EE is BECAUSE of celiac. I realize celiacs often times have other allergies/intolerances/autoimmune disorders. I also know that people with EOS disorders often have lots of allergies. I think too little is known about EOS disorders right now though to say one way or another. The leading research is being done in Cincinatti. There's also another eosinophilic center at CHOP (Children's Hospital of Philadelphia). I've been trying to read up as much as possible, but I'm still far from an expert on the subject.

Eosinophils are immune cells. As such, if they appear in too-high numbers, they can do so in response to any kind of allergic response (or parasitic responses, too). Eosinophilia is not *strictly* a result of celiac disease. However, it is quite possible for the eosinophils to show up as part of an allergic response to gluten or wheat.

[azmom3]

Eosinophils are immune cells. As such, if they appear in too-high numbers, they can do so in response to any kind of allergic response (or parasitic responses, too). Eosinophilia is not *strictly* a result of celiac disease. However, it is quite possible for the eosinophils to show up as part of an allergic response to gluten or wheat.

This is how I understand it, too. But from what I understand, a person may see that wheat is a trigger, but not all gluten, if that makes sense? They could find out eventually that all gluten triggers EOS as well, but I don't think it automatically means that....again, this is just the way that I understand it so far.