Cross Posting Test Results

[plumbago]

Hello everyone,

I'm cross posting this...

For those experts at understanding test results, I would appreciate any feedback!

Going over my lab work, I was doing fine until I got to the part with the gliadin peptide Ab, IgA.

Tissue Transglutaminase AB, IgA (tTG Ab, IgA): 13.2 - reference range, less than 20, so this is within range

Gliadin Peptide Antibodies, IgG, : 11.1 - reference range, less than 20 so this is within range

Gliadin Peptide Ab, IgA : 40 - reference range, less than 20, so this is NOT within range.

Does anyone know what this means? I typed the three tests pretty much word for word.

Also, my hemoglobin was out of range, low (11.5), and so was my MCHC (Mean corpuscular hemoglobin concentration), also low (29.9).

I've been gluten free (with a diagnosis of celiac disease) for just over a year. And pre-diagnosis my whole celiac panel was high high high.

On the other place I posted my message, a user replied that the antigliadin IGA (aka AGA IGA) means I am still being exposed somewhat. "Eating out, shared kitchen, toiletries, prepared/packaged foods...

"Unless there are bits of gluten entering your intestines, that wouldn't normally show up. However, if you had very high positive tests one year ago, that could be slow coming back to normal. Typically, you expect to see normal or near normal levels after a year except when the diagnosis tests showed very high values. Do you have your previous test values?

"The anemia also indicates that you probably have some malabsorption going on, so possibly still active celiac disease. I'd get stricter with the diet and schedule repeat tests in 3 or 6 months."

I replied back to him/her that, the thing is, I'm not sure I'm comparing apples to apples. Meaning, the previous blood work I had done was in October 2010, and at that time, the test I had done (one of 4) was "deamidated gliadin abs, iga." It was not the "gliadin peptide ab, iga." I'm not sure if that's the exact same or not.

In October 2010, the deamidated gliadin abs, iga was "normal" - 11. And the range was 0-19.

Another question on my most recent test, in light of his/her answer (I said) is what about the other two tests from this last time? That is to say the tTg Ab, IgA, and the Gliadin Peptide AB, IgG both of which were normal? Can I take that as a sign of progress?

Thanks everyone.

Plumbago

[sb2178]

Nope, they're not. Deaminated is a slightly different form of the molecule. So you are comparing apples to pears. But, because it was negative in October, you probably had no or negligible exposure last fall, but have made some change over the winter/spring that re-introduced enough gluten for your immune system to notice.

TTG being normal is very good. TTG marks intestinal damage, but it seems like there has to be a fair amount of damage before it leaks into the blood.

AGA IgG is less important (it's mostly not incredibly well associated with celiac disease, compared to other tests). If it's negative, that good but not incredibly meaningful. If it's possitive, that marks gluten exposure with an immune reaction. Like the AGA IgA, that's not so good.

Having positive IgA AGA is a problem. The older celiac maintainance guidelines used to suggest that lower absolute numbers were better (even when under the positive threshhold). So, like I suggested before, try to reduce potential exposures and re-test.

Conceivably, you could have an elevated AGA IgA but normal DGP IgA because gliadin is processed by the body to become deamidated gliadin... but I'm not sure that's something to worry about or consider.

[plumbago]

Hi sb,

It's interesting how much more detail you go into than my doctor did, who just called me in response to a fax I sent him. I sent him the fax to help me understand the elevated level.

I sent the fax last week (twice) inquiring about the high test result. The doctor said that that test is not a test for gluten, that there is no test for gluten, can't measure it. He says it's an antibody test. I think that is what you're also saying, and the doc is probably being too literal or even facile. He says he wouldn't worry about that particular test being high. He said if I'm really concerned that I should mail the results to the gastroenterologist. I was not all that satisfied with his response, but now that i'm working full time, I do not have the luxury of going hither and yon till I get a decent doctor who knows about Celiac disease; gluten; cross contamination; and the ins and outs of reading test results. (Mini rant over; apologies.)

Plumbago

[Skylark]

Your doctor was being facile. If you want to really understand the result, you need to ask him specifically whether the test was for anti-gliadin antibodies, or anti-deamidated gliadin peptide (DGP). If you know what diagnostic lab ran the test, it might be easier to call the lab.

One result is more problematic than the other. It's not uncommon to find anti-gliadin antibodies, but the DGP antibodies mean the celiac disease process is still going on in your intestines.

[plumbago]

Thanks Skylark. Maybe I'll call the lab tomorrow. Sigh.

Now, I've got to post about yellow fever vaccines. Doc said ok, but I wonder. It has gelatin in it.

Plumbago