Anxious To Understand Test Results

[WorriedFather]

Hi,

My dauther will be 5 yo in a month, and has always been the smallest in her class. She's on the lowest line of the range for his age, and has always been. She has also been experiencing some "not-so-solid" poop on a chronic basis, although we would not call that diarrhea, except when ill. Other than that, she is just like any other child.

The doctor suggested we run a few tests to make sure there was no allergy or anything to justify her smaller size. Perhaps he had celiac in mind, but didn't say anithing specific at that time. The results just came in, and it appears that:

- anti-gliadin IgG is the only positive (12 U/ml, with neutral ranging from 7 to 10 and positive higher than 10)

- everything else is negative (anti-gliadin IgA, EMA IgG, tTG IgA, tTG IgG, all below 5 U/ml with N<7 U/ml). Some IgE stuff was negative as well/

I have several questions:

- Will a biopsy be the only way to get the definitive answer for celiac, or are there some possible conclusions on these results alone? I read that tTG IgA and tTG IgG are the most important tests and they are negative here...

- If there ia a risk for celiac, is this disease often diagnosed at 5 yo? I read that it's often diagnosed before 1 or 2 yo after starting eating gluten, or can be discovered quite late with adults after being "underground'.

Thanks in advance, I know I'll get some "official" answers when speaking with the doctor early next week, but I could'nt wait to get some informed advices before then...

[Lisa]

Hi,

My dauther will be 5 yo in a month, and has always been the smallest in her class. She's on the lowest line of the range for his age, and has always been. She has also been experiencing some "not-so-solid" poop on a chronic basis, although we would not call that diarrhea, except when ill. Other than that, she is just like any other child.

The doctor suggested we run a few tests to make sure there was no allergy or anything to justify her smaller size. Perhaps he had celiac in mind, but didn't say anithing specific at that time. The results just came in, and it appears that:

- anti-gliadin IgG is the only positive (12 U/ml, with neutral ranging from 7 to 10 and positive higher than 10)

- everything else is negative (anti-gliadin IgA, EMA IgG, tTG IgA, tTG IgG, all below 5 U/ml with N<7 U/ml). Some IgE stuff was negative as well/

I have several questions:

- Will a biopsy be the only way to get the definitive answer for celiac, or are there some possible conclusions on these results alone? I read that tTG IgA and tTG IgG are the most important tests and they are negative here...

- If there ia a risk for celiac, is this disease often diagnosed at 5 yo? I read that it's often diagnosed before 1 or 2 yo after starting eating gluten, or can be discovered quite late with adults after being "underground'.

Thanks in advance, I know I'll get some "official" answers when speaking with the doctor early next week, but I could'nt wait to get some informed advices before then...

Welcome and we can try to answer some of your quesitons.

Here is some infomation on the Serologic Panel for Celiac -

Open Original Shared Link

I have always understood that testing for children under the age of five is less reliable than for adults. Yet, still the current testing available are not as reliable as we would like at this time. I have great hopes for the future. A biopsy can confirm Celiac, although a negative result cannot rule it out either.

Do you or your spouse have a history of intestinal disorders or other autoimmune conditions? The tendency for Celiac may be genetic.

[WorriedFather]

Thanks for your answer.

No, we have no specific history that could be related to celiac, that we know of.

Right now, it was just a blood test check, and this IgG anti-gliadin result, positive by a small amount.

So I'm crosing fingers for my daughter!

[Darn210]

Blood tests can be unreliable in young children . . . so can the endoscopy. They may want to do an endoscopy anyway. If they do, ask them to check for disaccharidase deficiencies. This is a lab test that can be done on one of the biopsy samples. They did it for my daughter because I asked them to check for lactose intolerance. They may automatically do this test but asked to be sure. My daughter's blood test came back (very) positive. Her "official" endoscopy for Celiac came back inconclusive. However, the disaccharidase test showed that she had a generalized disaccharidase diffenciency which is indicative of an intestinal disease such as Celiac. You may have read that many Celiacs are also lactose intolerant. That's because the first thing that gets damaged in the villi is the area (tips) that produce the enzyme that processes the lactose. What you rarely hear, is that several other enzymes are also produced in this same area and that's what I had checked on my daughter.

Here's the source for my above info:

Open Original Shared Link

It may still be a gluten intolerance/celiac issue . . . and the way to determine it may be a trial gluten-free diet. You may want to talk that option over with your doctor also.

It may be something totally different. My son ended up having his tonsils taken out because of what I'll call poor growth. The doc was looking for a source of chronic inflamation. My son's tonsils were huge although he did not have a history of ear infections, strep throat, snoring or sleep apnea. They decided to go ahead and have them removed. Afterwards the ENT doc said that it was a good move . . . they were nasty with an old imbedded infection. His growth got better after that. (and just an FYI, my son did go through a trial gluten-free diet for 6 months prior to having his tonsils removed just to see if gluten could be a problem since it was for his sister.)