Don't Understand Test Results

[Carollynb]

Hello All.

My son's blood tests came back but I don't really understand them. His allergist only said that he doesn't have celiac's according to the test results.

Here's what I'm looking at:

Endomysial Antibody IgA Negative Negative

t-Transglutaminase (tTG) IgA 1 U/ml 0-3

Negative 0-3

Weak Positive 4-10

Positive >10

Tissue Transglutaminase (tTG) has been identified as the endomysial antigen. Studies have demonstrated that endomysial IgA antibodies have over 99% specificity for gluten sensitive eneropathy.

Immunoglobulin A, Qn, Serum 23 mg/dL 20-100

The rest of the results are for his food and environmental allergies. The interesting thing about those is that his wheat allergy only shows to be a class II allergy but whenever he's exposed to foods with wheat (very rarely!) he has a reaction in less than 24 hours, sometimes in less than 8, like diarrhea, hot, itchy skin followed by these starnge blister/bumps that sometimes take a week or more to clear.

Would the daily antihistamine (Zyrtec) affect his results or lack of exposure to gluten? (His diet has been gluten-free for almost 2 years now.)

Also, does anybody have a latex allergy (I am but never tested) and know what the following results mean?:

IgE+Latex

Immunoglobulin E, Total 157 IU/mL 0-352

K082 Latex .05 Abnormal kU/L .05-.07

Thanks for taking the time to read this.

[Rachel--24]

I guess I'm a little confused....has he been on the diet for 2 years now...with only rare exposures to gluten? That would make any testing for Celiac Disease unreliable.

Even if your son has Celiac he would not test positive having been on the diet for such a long time.

He would have to have gluten as a constant in his diet for at least 3 months prior to testing.

[ShayFL]

And basically he is IgA deficient making all of those IgA tests useless.

[Carollynb]

I guess I'm a little confused....has he been on the diet for 2 years now...with only rare exposures to gluten? That would make any testing for Celiac Disease unreliable.

Even if your son has Celiac he would not test positive having been on the diet for such a long time.

He would have to have gluten as a constant in his diet for at least 3 months prior to testing.

Gluten free for almost 2 years. His toothpaste, soap, etc. has been gluten-free, mostly by accident but thank goodness!

3 months on gluten!?! I don't think I could take seeing him miserable for so long; not to mention tolerating his mood swings. I know I will keep him on a gluten-free diet anyway but it would certainly be nice to have an actual diagnosis.

When he was born he had severe reflux (treated with meds and a cow's milk protein free formula), projectile vomiting, almost head to toe eczema (still has some that flares), extreme fussiness, diarrhea, bouts of blood in his stool (GI only tested stool, no other tests), and anemia.

He was dx with a milk allergy and tested for some food allergies (milk, nuts, eggs) at 12 months of age and retested at 24 months and 3 yrs.

Like I said, his allergist doesn't believe he has celiac's bc of blood tests and the fact he is not malnourished. He also thinks if I use Enterolab for testing I'll get a positive result because they know we (as parents or patients) want that answer. I think that's ludicrous to think that a lab would "falsify" results just to appease patients.

What is involved with a gluten challenge? Does that just show sensitivity or intolerance?

Thanks for your reply to this.

[Carollynb]

And basically he is IgA deficient making all of those IgA tests useless.

What does that mean? What is Endomysial Antibody IgA versus Immunoglobulin A, Qn, Serum?

[ShayFL]

Your son IgA was 23 and the range starts at 20. Ranges are just that. Ranges. And what is normal for one may not be normal for another. You need to have a good amount of IgA (and your son doesnt have hardly any) to produce the IgA antibodies that they tested all of the others in the first place. He doesnt produce much of those IgA's....so all of those IgA tests are useless.

And Enterolab does not falsify results. I tested with them 2 years ago and everything came up negative. Everything. Some were close, but I was negative. And now positive. If they were on a crusade to just appease patients and get people to go gluten free then I would have tested positive the first time. I didnt.

[Rachel--24]

What does that mean? What is Endomysial Antibody IgA versus Immunoglobulin A, Qn, Serum?

Endomysial Antibody IgA is an antibody which the immune system produces during active Celiac Disease.

When there is no gluten in the diet the immune system does not produce these antibodies.

You can go here for an interpretation of the antibody tests.

https://www.celiac.com/articles/57/1/Interp...ults/Page1.html

Immunoglobulin A, Qn, Serum....this test is to determine how much IgA is produced. Some people are deficient which means that they cannot produce enough IgA to test positive even if they do have active Celiac Disease. If this is the case they would need to test for IgG antibodies instead of IgA.

There is an Endomysial Antibody IgG test available and that can be used in cases of IgA deficiency.

Your son tested on the low end of the reference range for IgA....I dont know that he is deficient since he is producing some....although I'm not sure that its enough to have positive bloodwork.

Regardless, your son is not consuming gluten and has been on the diet for too long to have any of these tests come back positive. The allergist should have informed you that the tests are useless when already on the gluten-free diet. I'm not sure that this Dr. has alot of knowledge/experience with diagnosing Celiac Disease??

What is involved with a gluten challenge? Does that just show sensitivity or intolerance?

A gluten challenge simply means to go back on gluten for the purpose of having the tests done....or to see how the body responds when gluten is reintroduced....and then again when gluten is eliminated.

Without the tests you will not be able to diagnose Celiac Disease. He may be intolerant to gluten and yet not have Celiac Disease. Enterolab cannot diagnose Celiac Disease.....they can only tell you whether or not your son is sensitive to gluten. If you already know that he improves while on the diet there is really no reason to test with Enterolab as it wont necessarily tell you anything that you dont already know.

Also, Enterolab claims to be able to detect antibodies in stool up to 1 year after the removal of gluten from the diet.....but your son has been off gluten for twice that long.

You can have the gene testing to see if your son carries either of the main Celiac genes. Having the genes doesnt necessarily mean that he has Celiac.....many people have the genes but dont ever develop the disease. However, if he is responding negatively to gluten and has a positive response to the diet it may be that he does have Celiac if he has a genetic predisposition.

Also, why would the allergist think he would be malnourished if he's been on the diet for 2 years now?? The point of the diet is to avoid damage/symptoms. If he DOES have Celiac after 2 years he would be healed and malabsorption shouldnt be an issue.

If he is still having problems after 2 years on the diet....and when no gluten is sneaking in... I would be looking into other factors.

[Rachel--24]

Another thing about Enterolab....The Dr. who runs the lab (Dr. Fine) has never published anything for peer review. I, myself have been waiting for a few years now....however, it doesnt appear that he is willing to publish his findings.....which to me indicates that there may be problems with the testing.

Basically, at this point noone really knows how valid the Enterolab tests are....and it is still an unproven method of testing.

[tipnpat]

He also thinks if I use Enterolab for testing I'll get a positive result because they know we (as parents or patients) want that answer.

I started to question all of the positive results I was seeing with Enterolab. I fully expected my two sons' tests to come back positive. But my older son who has IgG food intolerances (including wheat) testing completely absolutely negative and he is not IgA deficient. My other son's were positive. The numbers were only mildly elevated but Dr. Fine's explanation says it's like a pregnancy test and the number doesn't really matter. You either are or you aren't. I would still like for him to publish his work so it can be an accepted form of testing.

Tip

[gfpaperdoll]

If Dr Fine publishes his work that is not a sign that anyone will accept it. You might want to read the book "Good Calories Bad Calories" by Gary Taubes, that explains all these "studies" & published papers used as fact in the U.S.

[tipnpat]

If Dr Fine publishes his work that is not a sign that anyone will accept it. You might want to read the book "Good Calories Bad Calories" by Gary Taubes, that explains all these "studies" & published papers used as fact in the U.S.

Believe me, I'm not a believer in studies and "the facts." I think it is all skewed and so thick in numbers and circumstances that it can't possibly be absolute. I just meant that if he published something then it would at least be more open for debate. As it is, he's just dismissed. I'm a believer.

Tip