Negative Iga, Positive Igg Deamidated Gliadin/ttg

[sdingeldein]

Hello,

My wife was diagnosed with Celiac disease 6 weeks ago found via biopsy on a routine upper endoscopy. Subsequently she was serologically positive for Deamidated Gliadin and tTG for both IgA and IgG. She is also positive on the genetic testing.

My eldest daughter got her tests back yesterday and they are a mixed bag.

Deamidated Gliadin IgA is negative (10)

Deamidated Gliadin IgG is moderate to strong positive) (77)

tTG IgA is negative (<2)

tTG IgG is positive (10 with positive >9)

Endomysial antibody IgA negative

Serum IgA is normal (128) so she is not IgA deficient

My presumption is that the next test to do is the genetic testing. If negative, it is unlikely she has celiac disease, but she probably needs a biopsy as the gold standard.

Thoughts?

[sa1937]

Hello,

My wife was diagnosed with Celiac disease 6 weeks ago found via biopsy on a routine upper endoscopy. Subsequently she was serologically positive for Deamidated Gliadin and tTG for both IgA and IgG. She is also positive on the genetic testing.

My eldest daughter got her tests back yesterday and they are a mixed bag.

Deamidated Gliadin IgA is negative (10)

Deamidated Gliadin IgG is moderate to strong positive) (77)

tTG IgA is negative (<2)

tTG IgG is positive (10 with positive >9)

Endomysial antibody IgA negative

Serum IgA is normal (128) so she is not IgA deficient

My presumption is that the next test to do is the genetic testing. If negative, it is unlikely she has celiac disease, but she probably needs a biopsy as the gold standard.

Thoughts?

While genetic testing might be interesting, it is by no means diagnostic. There are people here who do not have the classic celiac genes but do indeed have celiac. With your daughter's positive DGP test results, I'd say she has it.

The next step would certainly be an endoscopy/biopsy if you're inclined to go that route. It's entirely possible to have a negative biopsy and still have celiac if damage is patchy and biopsies are taken in the wrong areas (or vice versa to have a positive biopsy and negative blood tests). If she will have the endoscopy/biopsy, make sure she does not go gluten-free until all tests are done.

You might like to read these fact sheets from the U of Chicago Celiac Disease Center: Open Original Shared Link

Hope this helps a bit...I'm sure others will chime in with their thoughts. Welcome to the forum!

[sdingeldein]

While genetic testing might be interesting, it is by no means diagnostic. There are people here who do not have the classic celiac genes but do indeed have celiac. With your daughter's positive DGP test results, I'd say she has it.

The next step would certainly be an endoscopy/biopsy if you're inclined to go that route. It's entirely possible to have a negative biopsy and still have celiac if damage is patchy and biopsies are taken in the wrong areas (or vice versa to have a positive biopsy and negative blood tests). If she will have the endoscopy/biopsy, make sure she does not go gluten-free until all tests are done.

You might like to read these fact sheets from the U of Chicago Celiac Disease Center: Open Original Shared Link

Hope this helps a bit...I'm sure others will chime in with their thoughts. Welcome to the forum!

Thanks, your comments are on line with my thinking and what I've been reading. I certainly am inclined to move on with a biopsy (if positive = she definitely has it, if negative, she should probably consider going gluten free).

[sa1937]

Thanks, your comments are on line with my thinking and what I've been reading. I certainly am inclined to move on with a biopsy (if positive = she definitely has it, if negative, she should probably consider going gluten free).

I think this is your opportunity to go it since she is still eating gluten. It at a later time you would want it done, she would have to do a gluten challenge. For adults that means eating 3 to 4 slices of bread for 3 months. Not a pleasant situation for most people considering it could still come in with a false negative. Let us know how it turns out.

[Skylark]

My presumption is that the next test to do is the genetic testing. If negative, it is unlikely she has celiac disease, but she probably needs a biopsy as the gold standard.

I would be very concerned about the deamidated gliadin IgG, particularly since it's a marker your wife had too. It's a pretty sensitive test and the only way there could be deamidated gliadin for her to develop antibodies is if there is at least mild intestinal damage and release of TTG. There may not be enough damage to see on biopsy yet (the negative TTG suggests not) but she is very likely so-called latent celiac and should probably be eating gluten-free.

[sdingeldein]

Thanks, all. That is pretty much my read on the numbers as well. She is, depending on biopsy result, silent or latent.

SD