Help With Understanding Labs

[ocdsgirl]

My son recently had a positive celiac screen and yesterday they did an endoscopy and colonoscopy to also look for crohn's or colitis (I have colitis). At this point he will be 12 in a few months and only weighs 58 pounds and is in the 25th percentile for height, slightly anemic and slightly low vit. d, and has arthritis. Right away they said that he did not appear to have either crohn's or colitis (yay!), but he might have celiac. They want to wait for biopsy labs. I also finally received the actual lab results for everything regarding blood work and really don't understand them. Here's a partial list:

ESR- 8, white blood cell count- 4.2 (L), hemoglobin 12.6 (L), tTG 56 (H), IGM serum- 39, IGG serum- 1026, positive ANA, speckled ANA pattern, endomysial antibody IGA screen- 1.5, endomysial antibody IGG screen- 1.5, ASCA Elisa IGG specific- 12.0, ASCA elisa IGA specific- 12.0, anti-ompc elisa IGA specific- 8.4, anti-cbir1 Elisa- 36.4 (H), neutrophils-auto diff- 1390 (L), IGA serum- 346(H)-normal being anything between 53-204. There was a bunch of other stuff, but I think I've punished everyone here enough already!

I guess I'm just paranoid about what they will tell me with the biopsy labs. I also wonder if I should have my little girl screened. I know you guys aren't my doctor, but freindly input would be much appreciated:) P.S. please forgive typos/grammatical errors!

[ravenwoodglass]

You are done with testing and IMHO a dietary trial with the gluten free diet would be a good way to go. The rate of false negatives with blood and biopsy is higher than we would like and you don't have to wait for the results of the biopsy to see if the diet helps him.

In families where one member has celiac it is advised that all first degree relatives, you and his Dad and all sisters and brothers be screened.

[Skylark]

Your son has markers of autoimmunity, probably at least partly from his arthritis. Anti-tTG is an autoimmune antibody. It's a major celiac marker, but it can also show up in people with arthritis who are not celiac. ANA (anti nuclear antibodies) is another marker of autoimmunity that could be from the arthritis. It could also be nothing because 5% of the general population has positive speckled ANA. Anti-cbir1 is a new test that is part of the Crohn's panel, but a positive result on only that test is not a concern, especially with the negative endoscopy. (That IS good news!) Your doctors are waiting for the biopsy because the other big marker for celiac, anti-endomysial antibodies, is not positive.

I hope the biopsy results give a clearer diagnosis, but it's worth trying him off gluten even if the biopsy doesn't show much because of the anti-tTG, low vitamin D, and anemia. Those results alone are plenty of evidence to try the gluten-free diet.

[ocdsgirl]

Okay,

obviously still waiting to hear back on the biopsy results, but I did notice that the GI doc made this note on all her paperwork she mailed to me and the pediatrician from our labs and visit last week:

IMPRESSION- Michael most likely has reactive arthritis associated with celiac disease.

Other considerations- Crohn's with assciated arthritis.

I guess it is worth mentioning that he has only had the arthritis in the 2nd toe of his left foot (plus he has recently been complaining of lower back pain off and on), and I get the impression that the rheumatologist and GI doc think the arthritis might be secondary to something else.

Thank you for your responses! It sheds a little light on the results for me:)

[nora-n]

The IgA is a total IgA, and they have to run that one just to check if the IgA type tests are valid.

Celaics have more frequently low total IgA and then the IgG type tests must be done instead, as the IgA type tests are not valid.

Here they called the tissue transglutaminase tests for endomysium antibody, but the EMA does not have a IgG test.

The EMA was not done, just the ttg test, both IgA and IgG versions.

I am sure they call it endomysium so the older doctors will know that they ran some kind of celiac test....

There is also the antigliadin test, which is old but it can be useful, and the new deamidated gliadin antibody test.

About the range of the above ttg test that was called endumysium antibody test, was it negative or in the grey range?