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Bloodwork Question...

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My 3 year old daughter was tested for celiac about 6 months ago...the antigliadin IgA's and IgG's were both elevated but the reticulin and endomysial antibodies were negative. Because the antigliadin antibodies were elevated, the ped GI wanted to retest her, which we just did last week. Course they performed different tests this time, so we're unable to compare, but they did the endomysial and the ttg tests which were negative. Her total IgA's (not antigliadin specific) were actually elevated, so she's not IgA deficient. Just wondering if I should interpret this bloodwork as an absolute negative. The allergist did suggest trying a gluten-free diet due to the possibility of a wheat intolerance instead of celiac. Just wondering what your thoughts are! Thanks in advance!

Sue

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Kid's with Celiac by Danna Korn has a chart in it for test results.

+ EMA-Iga/tTG

+AGA-IgG

=Interpretation - Celiac Disease almost certain

That is directly from the book and I am not a doctor!

Laura

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So you're saying if the endomysial antibody is positive, along with the anti-gliadin IgG...then celiac is almost certain? Well, my daughter's EMA was negative on two different occasions. Funny, the allergist said that many people can have elevated anti-gliadin IgG's, but the IgA's were the ones that were most correlated with celiac. I would definitely be inclined to believe this man - he's very knowledgable and very well respected. (He's also very open minded, which is definitely a plus!) Thanks for your reply!

Sue

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Your allergist is correct -- elevated IgG for gliadin is not necessarily specific for celiac. EMA is both very specific for celiac and a very good predictor (so a negative means negative most of the time...). IgA can be negative because you are celiac and don't have any, or negative because you aren't celiac at all. If your daughter's came back elevated, you know she actually has IgAs running around. Anyhow, a negative EMA and a negative tTg is going to be negative for celiac in most people's cases....

joanna

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Don't really want to cause more confusion, but I thought I should point out that a positive IgA antigliadin test shows a reaction to gliadin(gluten), negative IgA tTg and EMA mean that the damage to the intestine is not severe enough to be called celiac, but your allergist is correct that it could be an intolerance to wheat (or gluten) and just not full blown Celiac. No one can say for certain if your daughter will get Celiac Disease later, but you could avoid it all toghether by trying the diet. I assume she must have symptoms or you wouldn't be testing her? If you are finished with testing at this point then it wouldn't be a bad thing to try the diet like the allergist suggested. If her symptoms improve, then you can be pretty sure that gluten is bothering her. You could also have her gene tested. Enterolab does a very good gene test, that included the genes for gluten intolerance, as well as the main genes for Celiac. It costs about $150. You don't need a doctors order either, and you do the test at home. Some people like the idea of having the gene test be private, since they don't want to be discriminated against by future insurance companies who don't want to cover you because you have a genetic disorder...So with Enterolab you have the choice of sharing the results with your doctor or not.

God bless,

Mariann

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Thanks for all the info! Yes my daughter does have symptoms, but she was actually diagnosed with inflammatory bowel disease. I still am a bit skeptical about the diagnosis, so I find myself questioning other possibilities. Her ped GI said she could have celiac in addition to IBD so that's why she's been tested. Her symptoms include loose, foul stools with mucous and, on occasion, trace amounts of blood. We first thought it was a dairy allergy. When we took dairy out of her diet, the blood increased. We did the elimination diet twice - the first time for 3 weeks and the second for 2 weeks. Both times, the blood in her stool increased. I know celiac doesn't normally cause blood, but I'm just wondering why taking dairy out increased her symptoms. Seems she was eating more wheat at the time to make up for the lack of dairy, so it seems logical that she was having some sort of reaction to wheat. But I guess you could also explain it by saying that gluten is tough on the body...it can be even tougher on a damaged intestinal tract causing more blood to appear. Anyway, enough about that. Thanks again for all the info! (By the way, I thought about Enterolab, but I'm very skeptical about the accuracy of the tests.)

Sue

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  Funny, the allergist said that many people can have elevated anti-gliadin IgG's, but the IgA's were the ones that were most correlated with celiac.

Unfortunately, it is very true... and it means that there are A LOT of people out there with a gluten intolerance that aren't being helped. Elevated IgA is more specific to damage in the intestines... but an elevated IgG is nothing to ignore. The IgG antibodies are the one's that roam freely throughout the body and they are the one's, I believe, are causing the 'other' disorders that have been linked to celiac disease: thyroid, arthritis, diabetes...

If you have a gluten intolerance, evidenced by elevated antibodies to gliadin (IgA or IgG), then the only way to prevent from developing any disorder is to abstain from gluten.

The cure is simple and you don't need a prescription or a doctor to do it! :)

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