Confusion Of Test Results And What They Mean

[Sam'sMom]

My 8 year old recently had a celiac panel of tests done and I'm really not sure what any of them mean - my Dr's office doesn't really know either and I have an appt with a pediatric gastroenterologist coming up. (I don't know that he is a true celiac expert though). I do realize his results were very high in some categories though. My second son then had these results.

first son IgA > 150

second son 23 (weak positive)

first son IgG 31

second son 12 (negative)

first son (tTG) IgA >100

second son 6 (weak positive)

first son (tTG) IgG 5

second son 5

first son Endomysial Antibody IgA Positive

second son negative

first sone Immunoglobulin A, Qn, Serum 181

second son 123

How are people generally dealing with weak positives? He has no physical symptoms, but does have mild ADD and some learning difficulties. (He will also be extremely difficult to get on a gluten free diet because he's older and stronger willed)

I really don't want to do endoscopy with my kids, but I am inclined to get genetic tests for all of us. My husband and I had negative blood panels.

I suspect some of you have been through all of this, so whatever help you can lend would be very much appreciated.

Thanks

[Skylark]

first son IgA > 150

second son 23 (weak positive)

first son IgG 31

second son 12 (negative)

first son (tTG) IgA >100

second son 6 (weak positive)

first son (tTG) IgG 5

second son 5

first son Endomysial Antibody IgA Positive

second son negative

first sone Immunoglobulin A, Qn, Serum 181

second son 123

The test is missing from the first one. You need to find out what sort of IgA and IgG they are. It's probably anti-gliadin or DGP but they're really different tests. tTG stands for anti-tissue transglutaminase. It is the main celiac autoimmune antibody. Endomysial antibody is another autoimmune antibody that is very specific for celiac disease. The "Immunoglobulin A, Qn, Serum" test checks to see if they are making normal amounts of IgA. There should be a normal range given on the lab results.

I think your second son does need an endoscopy. He's probably starting to develop celiac. I'd be really nervous about the tTG. I wish you knew what the first test was... What is your doctor suggesting for follow-up? Your first son has really clear positive blood results so he is celiac and needs to be off gluten. You can probably be comfortable that he's celiac without the endoscopy because the antibodies are so high. I'm sure the Dr. told you at least that much?

[Sam'sMom]

Thanks for your reply. I know so little that I thought just those letters would tell someone who knew the tests what they were. The first IgA is Deamidated Gliadin Abs, IgA. The second is the same beginning name but with IgG.

Yes our primary told us he was obviously Celiac (1st son) and he has been gluten free since mid July, but we just got the second results and that's when she referred us to a GI. I just wanted to get some thoughts on this ahead of time. So you feel that if someone has a weak positive it might make sense to do the endoscopy to see if damage has started? Why do they so often suggest that everyone get the endoscopy, even when the blood tests are so clear? Thanks

[mushroom]

The Deamidated Gliadin test is what is called the DGP and is very specific for celiac in children. If that and his tTG were weak positive, I would think he might be well on his way to a positive result at a later time. But this is a test you really don't WANT to study and pass The fact that he has autism spectrum behaviors is even more suggestive that he has problems with gluten. Many children with thse types of behaviors improve markedly once gluten free, so if you can ever take him off gluten you might notice quite a difference in his stubbornness. I agree with Jestgar that to convince you and your husband you should go to the GI and have the endoscope for this child. It could turn out negative if the doctor does not take enough samples - there need to be at least 8 in current thinking - but if you can prevent him from developing full-blown celiac I think it would be worth it, and with both boys eating the same thing it would be much easier (for you, and to convince your other son that this is the way to go). Even if the endoscopy were negative I would still trial him gluten free and look for behavioral changes.

[Skylark]

IgG and IgA are general classes of antibodies. The anti-tTG or anti deamidated gliadin (DGP) tell what the antibody is against.

ONLY a person with celiac disease makes deamidated gliadin so you can't see those antibodies in a healthy person, and it's an extremely sensitive and specific test for celiac disease. The weak positive tTG lets you know that it wasn't a false positive from a lab error. I agree with Shroomie that if you're not willing to take him gluten-free based on the labs, he definitely needs an endoscopy so you can see what is going on. The thing to keep in mind is that developing celiac disease can be a process, not necessarily an off/on. It would be safest to get him off gluten. Getting him off gluten may help the ADD and learning disabilities.