Help With Test Results Please!

[Darcie]

Would somebody please help me? I just got my test results back and I'm confused!

Antigliadin Abs, IgA 1 Neg 0-4

Antigliadin Abs, IgG 1 Neg 0-9

t-Transglutimase (tTG) IgG 1 Neg 0-5

Endomysial Antibody IgA Neg

**Immunoglobulin A, Qn, Serum 42 70-400

I have Hashimoto's thyroiditis (hypothyroidism) and fibromyalgia (could all these symptoms be celiac disease?). My most recent Vit D test was deficient AGAIN (it has been for at least 2 years--this time not just low but REALLY low). I'm not having a lot of the stomach problems that some with celiac have but a lot of the other "silent" symptoms. I have a GI apt in 3 weeks and having to wait knowing what I'm eating could be hurting me more is driving me crazy!! I can deal with the gluten free diet I just need to know if it's celiac or not. I know there's somebody out there with a lot more experience in this than me--what are your thoughts?

[happygirl]

You may want to ask your doctor if your IgA total (42) is considered IgA deficient. If you are IgA deficient, the AGA IgA, EMA IgA, and tTG IgA tests won't be as accurate for you.

Keep eating gluten until your appointment and all testing is completed.

Ask your doctor about the new pill cam for diagnosing Celiac. It appears to be more accurate than a regular biopsy.

for info: Open Original Shared Link

From: Open Original Shared Link

Selective IgA deficiency (SIgA deficiency)

SIgA deficiency occurs 10 to 15 times more commonly among people with celiac disease compared to the general population [19]. Patients with SIgA deficiency will lack IgA antibodies including endomysial antibody, tTG and IgA AGA. To detect celiac disease in patients with SIgA deficiency an IgG antibody, typically IgG AGA, needs to be performed together with total IgA level. Alternatively, one may screen with IgG anti- EMA or IgG anti-tTG, though these are not widely available. Typically the patient with celiac disease and SIgA deficiency will have a positive IgG AGA and absent total IgA level. This combination should prompt a biopsy, whereas an isolated positive IgG AGA would usually not.

[Darcie]

Thank you so much for your help--I assumed my IgA total of 42 was deficient when the lab report said normal was 70-400 and it was written in bold indicating out of normal limits. My family physician had nothing else to say regarding the results (I know she didn't know what to do as I gave her the celiac panel of blood tests to perform) but she did refer me to a GI doc.

So, from somebody who has not as well versed in this as you, let me try to sum up.

It looks like I very well could have Selective IgA deficiency. However, because that number is low the other tests are not accurate and "to detect celiac disease in patients with SIgA deficiency an IgG antibody, typically IgG AGA, needs to be performed together with total IgA level."

And those results would need to look like this to diagnose celiac disease: Typically the patient with celiac disease and SIgA deficiency will have a positive IgG AGA and absent total IgA level. This combination should prompt a biopsy, whereas an isolated positive IgG AGA would usually not.

So, it looks like more blood tests, wait and see what they say and then possibly a biopsy. I sure do hope the pill camera is available--the alternative doesn't sound like fun...

Thanks again for clarifying this for me--it sure makes it easier to wait.

[aikiducky]

You might discuss going straight for the biopsy when you meet your GI doc. Blood tests are often negative in adults, even if they are not IgA deficient, and some people still show positive on the biopsy despite the negative blood tests. Personally I would also consider trying the gluten free diet anyway, AFTER all the testing is done and whatever the test results are, to see if would help.

Pauliina