Dont Understand Lab Test?

[Teri35]

My daughter has had stomach aches off and on now for 7 years. It recently has got worse. Therefore, we we referred to a GI. They did lab work and gave it to me; however, i am having a hard time understanding it. The nurse told me they were leaning towards celiac disease; however, when i took my daughter in for her upper scope i mention it to him and said they dont know that yet. Here is her labs

IgA 305 H reference range: 33 to 200

Tissue Transglutaminase Ab igA 5 reference range: 20

Im so lost does this mean cause the numbers are high she has it or does not have it.. and the other one is low.. HELP>. im very worried about my daughter.. but i feel im totally blind to the results.. could you email me terichris@gmail.com or post here thanks..

[happygirl]

  Teri35 said:

My daughter has had stomach aches off and on now for 7 years. It recently has got worse. Therefore, we we referred to a GI. They did lab work and gave it to me; however, i am having a hard time understanding it. The nurse told me they were leaning towards celiac disease; however, when i took my daughter in for her upper scope i mention it to him and said they dont know that yet. Here is her labs

IgA 305 H reference range: 33 to 200

Tissue Transglutaminase Ab igA 5 reference range: 20

Im so lost does this mean cause the numbers are high she has it or does not have it.. and the other one is low.. HELP>. im very worried about my daughter.. but i feel im totally blind to the results.. could you email me terichris@gmail.com or post here thanks..

The IgA test (305) measures to see if your body makes enough IgA to do accurate testing. If it is low, other tests may be false negatives. According to this, your daughter is not IgA deficient. Total IgA testing alone is not a Celiac test, but is used to assess the accuracy of the other Celiac tests. If you don't make enough IgA, even if you have a raging case of Celiac, its hard to test positive for it.

The tTG IgA test (5) is a good test for Celiac, and based on that, she was not in elevated ranges indicating Celiac.

The bloodwork is not 100% reliable. It sounds like she had an endoscopy and they were looking for Celiac damage. You can have negative bloodwork and a positive biopsy, or test negative on both (and still have Celiac).

After all testing is done, you may want to consider a gluten free diet, to see if it alleviates her symptoms.

[Teri35]

  happygirl said:

The IgA test (305) measures to see if your body makes enough IgA to do accurate testing. If it is low, other tests may be false negatives. According to this, your daughter is not IgA deficient. Total IgA testing alone is not a Celiac test, but is used to assess the accuracy of the other Celiac tests. If you don't make enough IgA, even if you have a raging case of Celiac, its hard to test positive for it.

The tTG IgA test (5) is a good test for Celiac, and based on that, she was not in elevated ranges indicating Celiac.

The bloodwork is not 100% reliable. It sounds like she had an endoscopy and they were looking for Celiac damage. You can have negative bloodwork and a positive biopsy, or test negative on both (and still have Celiac).

After all testing is done, you may want to consider a gluten free diet, to see if it alleviates her symptoms.

[Teri35]

  happygirl said:

The IgA test (305) measures to see if your body makes enough IgA to do accurate testing. If it is low, other tests may be false negatives. According to this, your daughter is not IgA deficient. Total IgA testing alone is not a Celiac test, but is used to assess the accuracy of the other Celiac tests. If you don't make enough IgA, even if you have a raging case of Celiac, its hard to test positive for it.

The tTG IgA test (5) is a good test for Celiac, and based on that, she was not in elevated ranges indicating Celiac.

The bloodwork is not 100% reliable. It sounds like she had an endoscopy and they were looking for Celiac damage. You can have negative bloodwork and a positive biopsy, or test negative on both (and still have Celiac).

After all testing is done, you may want to consider a gluten free diet, to see if it alleviates her symptoms.

so from what you see, my daughter does not have celiac disease but maybe the scope will say different? Am i reading it right? thanks for getting back to me i really appericate it..

[happygirl]

It means on this test, you daughter didn't test positive for elevated tTG antibodies. It could mean she doesn't have Celiac, or it could mean that the testing didn't pick up on the damage she does have (if she has Celiac).

www.celiaccentral.org and www.celiacdiseasecenter.columbia.edu are good resources to check out.

When do you get the results of the biopsy?

[Teri35]

  happygirl said:

It means on this test, you daughter didn't test positive for elevated tTG antibodies. It could mean she doesn't have Celiac, or it could mean that the testing didn't pick up on the damage she does have (if she has Celiac).

www.celiaccentral.org and www.celiacdiseasecenter.columbia.edu are good resources to check out.

When do you get the results of the biopsy?

we will get those on tuesday; however, from my understanding sometimes it does not show up in children as there has not been enough damage done yet.. is that true? there is some other lab work they did but dont understand it all.. i just gave you the celiac part? what is dermatitis herpetitformis? it something at the end of the blood work about possiabilty of gultin sensitivity or the dermatitis? thanks for you help. Teri

[happygirl]

Yes, that can be true, but its usually more of a concern for younger children.

You'll need to ask your doctor why they think it may be Celiac. Also ask them what other conditions they are considering beyond Celiac. Ask them how many biopsies they took during the scope....they need to have taken 4-6 for it to be accurate (so that they don't miss any potential damage, since Celiac is a 'patchy' disease)

There is some other labwork, but the tTG is one of the most sensitive. The other bloodwork is: Open Original Shared Link

Info on celiac disease and DH:

Open Original Shared Link

[Ursa Major]

I want to add that even if they take TEN biopsies, a negative biopsy doesn't rule out celiac disease. Exactly because the surface area of the small intestine is huge, it is possible that the damage will be missed entirely. Plus, they never take biopsies any farther down than the upper third. But the damage may be below that.

Taking those biopsies is like going out onto a football field (thinking the grass may have a disease) and taking four or six tiny little samples of the grass to then examine under a microscope, to look for damage not visible to the naked eye. If the damage is only in some spots, how likely will it be that those six tiny samples will be taken from the damaged spots?

Unless the disease is so advanced that the grass is wilted and diseased looking and the damaged areas easily spotted and biopsied, a report saying that everything is fine is meaningless.

And so it is with the villi. Unless they are completely flat, and the intestine looking very inflamed and obviously diseased, the damage you can only see under a microscope is easily missed, even if they look with a little camera to choose the spots to be biopsied.

So, I would suggest giving the gluten-free diet a good try, at least six months, no matter what the tests say. The blood tests aren't very reliable, and neither are the biopsies. Trying the diet and the response to it is the best test for celiac disease, no matter what doctors think.

[Teri35]

thank you for your input i was wondering about that... i am very concerned about my daughter.. what symptoms do you are your kids have? My daughter just complains her stomach hurts alot and feels like throwing up... It recently has begun to happen every time she eats.... and then she broke out in the horriable rash for four days.. she scratched so much that i had to hold her hands down and rub lotion on her to keep her from cutting her skin with her nails.. not sure if that is related but thought i would throw it out there. thanks to both of you for everything..

  Ursa Major said:

I want to add that even if they take TEN biopsies, a negative biopsy doesn't rule out celiac disease. Exactly because the surface area of the small intestine is huge, it is possible that the damage will be missed entirely. Plus, they never take biopsies any farther down than the upper third. But the damage may be below that.

Taking those biopsies is like going out onto a football field (thinking the grass may have a disease) and taking four or six tiny little samples of the grass to then examine under a microscope, to look for damage not visible to the naked eye. If the damage is only in some spots, how likely will it be that those six tiny samples will be taken from the damaged spots?

Unless the disease is so advanced that the grass is wilted and diseased looking and the damaged areas easily spotted and biopsied, a report saying that everything is fine is meaningless.

And so it is with the villi. Unless they are completely flat, and the intestine looking very inflamed and obviously diseased, the damage you can only see under a microscope is easily missed, even if they look with a little camera to choose the spots to be biopsied.

So, I would suggest giving the gluten-free diet a good try, at least six months, no matter what the tests say. The blood tests aren't very reliable, and neither are the biopsies. Trying the diet and the response to it is the best test for celiac disease, no matter what doctors think.

[Ursa Major]

  Teri35 said:

thank you for your input i was wondering about that... i am very concerned about my daughter.. what symptoms do you are your kids have? My daughter just complains her stomach hurts alot and feels like throwing up... It recently has begun to happen every time she eats.... and then she broke out in the horriable rash for four days.. she scratched so much that i had to hold her hands down and rub lotion on her to keep her from cutting her skin with her nails.. not sure if that is related but thought i would throw it out there. thanks to both of you for everything..

What does that rash look like? It sounds like it could be DH (dermatitis herpetiformis), which is caused by celiac disease only. It is insanely itchy like that.

I have read that before there was a cause found for DH, and no treatment options, people with DH would sometimes commit suicide, because they would rather die than be that itchy!

The only valid treatment for DH is the gluten-free diet.