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Please Help Me Decipher These Results

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Hi,

I'm new here and am hoping you can help me understand my daughter's blood test results.

First some background. Dd is 8 years old and has multiple food allergies (IgE-mediated) and asthma. She's otherwise healthy and has no GI pain. She recently had pneumonia for the umpteenth time and her pediatrician decided to do some immune testing on her. Most of her results came back as normal but her t. transglutaminase says "21.3-low positive". "D Gliadin Pept" is negative and "Anti-translutaminase" is not back yet. IgA, IgG, and IgM are all normal.

Based on these results, what are the chances that my dd has celiac? I'll be speaking to her pediatrician tomorrow but am interested in hearing what you experienced people have to say.

Thanks!

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From everything I have read, a low positive ttg is like being "a little bit pregnant." False postives are very uncommon.

What you will find is most docs will not recommend a gluten free diet based on the one positive test. He will probably suggest the biopsy, which is the "gold standard" for celiac diagnosis.

I got pneumonia 7 years in a row, 3 times landed in ICU prior to celiac diagnosis. Last summer/fall was the first time in 8 years that I didn't get it.

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From everything I have read, a low positive ttg is like being "a little bit pregnant." False postives are very uncommon.

What you will find is most docs will not recommend a gluten free diet based on the one positive test. He will probably suggest the biopsy, which is the "gold standard" for celiac diagnosis.

I got pneumonia 7 years in a row, 3 times landed in ICU prior to celiac diagnosis. Last summer/fall was the first time in 8 years that I didn't get it.

Thank you very much for your reply. I spoke to the pediatrician today and she said that until the anti-transglutaminase comes back, it's premature to panic. She seemed to think there was still a good chance that dd does not have celiac. Is this accurate?

I just found out that my sister's dd tested positive to celiac on the blood test also and is awaiting an endoscopy. This does not bode well. :(

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The tissue transglutaminase test is an "Anti-transglutaminase" test. Being that your doctor specifically referred to two different tests by technically the same name, they may be referring to the anti-endomysial test which is technically an anti-transglutaminase test. Of the two, the IgA-tTG test is a more reliable marker based on the different testing procedures which also account for the longer turn around time of the endomysial tests.

With family history, multiple food allergies, asthma and other health issues you should be prepared for an upcoming endoscopy.

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The tissue transglutaminase test is an "Anti-transglutaminase" test. Being that your doctor specifically referred to two different tests by technically the same name, they may be referring to the anti-endomysial test which is technically an anti-transglutaminase test. Of the two, the IgA-tTG test is a more reliable marker based on the different testing procedures which also account for the longer turn around time of the endomysial tests.

With family history, multiple food allergies, asthma and other health issues you should be prepared for an upcoming endoscopy.

Thank you very much for your reply. The test results list different celiac tests:

DeamGLiadin Pept-0.20 (normal 0-7.19)

T. Transglutaminase-21.3 (normal 0-16)

Anti-transglutaminase-still awaiting results

So you're saying that the last 2 are the same thing? Is it the 21.3 that's the more reliable 1 or the 1 that's not back yet that's more reliable? I see you wrote that the IgA-tTg is more reliable but I'm not sure which 1 that is.

Also, are food allergies/asthma and celiac really related? Is there a higher incidence of celiac in the atopic population?

Thanks so much for your help!

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I would prepare yourself and your household for being gluten free as soon as the endo, if you choose to have one is done. It is highly likely that with positive blood work gluten free living is in your future. False positives on testing are very rare, false negatives are common. When you are done with testing please do give the diet a good strict try.

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Thank you. I am absolutely prepared to go gluten free if an endoscopy shows that she does indeed have celiac. Right now, I'm still at the stage of trying to figure out whether or not she has it and if an endoscopy is justified here. From your post, it sounds to me like it is.

On another note, I understand that even if she has no GI problems, it is necessary for her to be off gluten if she has celiac. Why is that? IOW, if it's not bothering her, why not leave things the way they are? Is it doing internal damage that we're not aware of?

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Thank you. I am absolutely prepared to go gluten free if an endoscopy shows that she does indeed have celiac. Right now, I'm still at the stage of trying to figure out whether or not she has it and if an endoscopy is justified here. From your post, it sounds to me like it is.

On another note, I understand that even if she has no GI problems, it is necessary for her to be off gluten if she has celiac. Why is that? IOW, if it's not bothering her, why not leave things the way they are? Is it doing internal damage that we're not aware of?

Celiac is an autoimmune disease. It can attack far more than just the gut. My signature and those of some other folks on the board can illustrate that.

Some of us can have serious impact to organs other than or before the gut. Some are even what the doctors call silent celiacs who never get GI issues at all.

Her other allergies may resolve once she is gluten free. I was unlucky and didn't show up in blood work. After many years of suffering an allergist tested me. I was allergic to 98 out of 99 substances I was tested for. The allergist told me that for him that was a clue that I might be celiac. I was diagnosed soon after and within a year all but 3 of the 98 allergies were gone. So was my asthma and a lot of other issues.

Celiac can also make the immune system so busy fighting the gluten antibodies (and body itself, hence the autoimmune aspect of the disease) that it easily gets overwhelmed and has a harder time fighting off germs and such. I spent my whole life constantly sick, chronic bronchitis and catching every virus that went around. I haven't had any colds or flus in the 8 years I have now been gluten free.

I hope you will give the diet a good strict try for a couple months after the endo. You don't need to wait on the results. False negatives on endos are common. We have 22 ft of small intestine and the damage can be spotty and get missed. Also some doctors don't recognize changes that can happen before the villi are totally destroyed.

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