Testing For Iga Deficient Individuals

[linda-r]

My teenage daughter has a 10 year history of acid reflux, GI pain, and a 2yr. history of occasional Raynaud-like symptoms. She had celiac serologies 3 yrs. ago by Quest. They were negative for the IgA markers, but she was IgA deficient (about 50% of normal). She will soon be retested by Prometheus Lab, which will be doing both the IgA makers and also Antigliadin IgG, with genetic testing if the serologies are negative. If the Antigliadin IgG only is positive, is this enough for a diagnosis of celiac, and would this justify a gluten free diet. Also, does presence of celiac genetics justify a life-long diet change if the serology tests are negative. Note: her intestinal biopsy was negative 18 months ago.

Thank you for any insight you can provide.

[lizard00]

My teenage daughter has a 10 year history of acid reflux, GI pain, and a 2yr. history of occasional Raynaud-like symptoms. She had celiac serologies 3 yrs. ago by Quest. They were negative for the IgA markers, but she was IgA deficient (about 50% of normal). She will soon be retested by Prometheus Lab, which will be doing both the IgA makers and also Antigliadin IgG, with genetic testing if the serologies are negative. If the Antigliadin IgG only is positive, is this enough for a diagnosis of celiac, and would this justify a gluten free diet. Also, does presence of celiac genetics justify a life-long diet change if the serology tests are negative. Note: her intestinal biopsy was negative 18 months ago.

Thank you for any insight you can provide.

I am IgA deficient, too, and unfortunately, my doc did not test the IgG markers. From what my own research and my GI have confirmed, in someone with an IgA deficiency, the IgG test is acceptable in the diagnostic process. In her situation, I would be surprised if the doc did not recommend a gluten-free diet if the IgG markers came back elevated. There is also an IgG tTG test, be sure that is run. As my GI told me, I could literally be half dead and would NOT test positive on an IgA based test for celiac. I just don't make enough of it.

Personally, and this is truly JUST my opinion, the presence of genes that are associated with celiac alone is not enough to justify a gluten-free diet. My son has at least one copy of the DQ2 associated with celiac, and he is not gluten-free. HOWEVER, if he had symptoms but tested negative on the tests, I would trial him on a gluten-free diet and if it worked, I would stick with it. He has tested negative, AND doesn't appear to have any symptoms as of now.

It's definitely your decision to make, and you should be respected for whatever you choose to do. If your gut is telling you to try the diet, but her blood tests come back negative, don't let someone talk you out of it. If it works, you have gained much. If it doesn't work, you've just eliminated another possiblity and can move to something else. No harm has been done.

I hope you find some answers soon!

[no-more-muffins]

How much IgA is "normal" then? My total IgA was 118. How do you know if you don't make "enough". What is enough?

[happygirl]

How much IgA is "normal" then? My total IgA was 118. How do you know if you don't make "enough". What is enough?

It depends on the reference range listed on your lab sheet. However, my guess would be if you are 118 then you are not deficient.

[linda-r]

Thank you for your responses. lizard00, I think you are giving excellent advice. I don't see the tTg IgG on her lab order sheet, although the AGA IgG is there. I may have to inquire about that test. Even if everything comes back negative, we will probably have her trial a gluten free diet for 3 months and see what happens. I think it would be hard to make the dietary changes permanent without some lab validation, although it may depend on if there is dramatic improvement with her symptoms from a dietary change. Ten years of stomach pain and other vague, non-childlike aches and pains are enough reason to try something as non-invasive and benign as a dietary change.

To NMN, her IgA level was around 60, which I recall was about half the normal range. I would guess 118 is normal, although there may be some variability from lab to lab on normal ranges.