Update And More Questions On Testing - Igg Deficient?

[beachbirdie]

I originally posted a request for help HERE and thought I should start a new topic since so much time has passed.

I finally received a packet with my mom's lab work. At first glance, I would assume mom is NOT celiac as she tested negative for all the celiac antibodies.

However, and this is puzzling, mom had these curious numbers:

Immunoglobulin A, QN, Serum: 54 (range 70-400)

Immunoglobulin G, QN, Serum: 480 (range 700-1600)

Immunoglobulin M, QN, Serum: 116 (range 40-230)

Now that I see mom deficient in both IgA and IgG, my question is whether I can rely on ANY of the celiac tests, since they test only those components.

Does a low IgG create the same accuracy issues as a low IgA does?

I'm a little angry that the doc said he would do the genes, and then didn't. However, I'm guessing it is a rare gift to have found the low IgG, I doubt most docs would have done that test.

Thanks ever so much for any insight you can give me!

[Skylark]

Yes, low IgG would create the same accuracy issues. If you have half the total antibodies, a test will have half the total signal in the ELISA. Cutting the signal in half could make a low positive into a negative pretty easily.

[beachbirdie]

Yes, low IgG would create the same accuracy issues. If you have half the total antibodies, a test will have half the total signal in the ELISA. Cutting the signal in half could make a low positive into a negative pretty easily.

Thank you very much! I have a whole new "rabbit hole" to dive into now. I've discovered the need to differentiate between Common Variable Immunodeficiency versus issues created by what the hematologist calls "smoldering" multiple myeloma; now trying to sort out a whole new world of information.

I was thinking these tests would put everything in a perfect perspective, turns out my mom's body is doing things that happen only to 1/1000 and 1/100,000 and we need to keep researching. I should have her buy me a lottery ticket or two.

[Skylark]

Wow, that's a TON of reading to do. It sometimes seems like we have to turn ourselves into doctors, which is a little frustrating. I hope you make great progress with your mom!

[IrishHeart]

I see Skylark has answered you and... Yes, I did see your original post which refreshed my memory.

Your Mom and My Dad and Me--are those people who hear "well, that is unusual, happens about 1-2% of the time or 16% of patients...or my fav "in my 35 years, I have NEVER seen a patient who presents with your"....blah blah ...." (gee thanks, doc that makes me feel encouraged )

And to echo Sylark, yes, we have to be our own best advocates and sometimes, our parents' advocates. Bless you for being so good to your Mom!

Regarding multiple myeloma...where do I start?. A friend of ours was Dxed with this years ago (long before I knew I had celiac) and when I found it could be related to gluten intolerance, I could have cried. If only I knew back then what I know now...

anyway, here are some things I found while researching MM.

https://www.celiac.com/articles/21542/1/Celiac-Disease-and-Paraproteinemia-Serum-Monoclonal-Proteins/Page1.html

https://www.celiac.com/articles/21836/1/Patients-with-Celiac-Disease-Multiple-Myeloma-React-Differently-to-Various-Kinds-of-Gliadin/Page1.html

Open Original Shared Link

Open Original Shared Link

Open Original Shared Link

Open Original Shared Link

I trust she is still on a gluten-free diet???

[Takala]

Yes, low IgG would create the same accuracy issues. If you have half the total antibodies, a test will have half the total signal in the ELISA. Cutting the signal in half could make a low positive into a negative pretty easily.

I nominate this for the best answer to any question this week, succinct, but easy to understand !

[beachbirdie]

I see Skylark has answered you and... Yes, I did see your original post which refreshed my memory.

Your Mom and My Dad and Me--are those people who hear "well, that is unusual, happens about 1-2% of the time or 16% of patients...or my fav "in my 35 years, I have NEVER seen a patient who presents with your"....blah blah ...." (gee thanks, doc that makes me feel encouraged )

I trust she is still on a gluten-free diet???

Wow, thanks for all the links, IrishHeart! Got my work cut out for me! I was aware that there could be a connection which is why I braved asking the hematologist for more tests...I knew he would not likely balk as badly as the general practitioner, neurologist, chiropractor, and osteopath did. I will get to reading.

Sadly, mom has not yet begun her gluten-free diet. We needed to keep her glutened until we got the bloodwork done satisfactorily. Also, we are 600 miles away and at this point we would not be able to manage the switch. We will be with her in just a few days now and start her on GAPS/SCD if she doesn't balk too hard. We are praying it helps. Thanks again, very much!

I nominate this for the best answer to any question this week, succinct, but easy to understand !

LOL, Takala! That's what I thought too!

[Skylark]

LOL, Takala! That's what I thought too!

Thanks for the kind words. I must have had a rare non-brain-fogged moment in there.

[beachbirdie]

Thanks for the kind words. I must have had a rare non-brain-fogged moment in there.

It seemed like kind of a dumb question for me to ask, but I thought (in my own foggy brain) I might be missing something!

I appreciate you taking the time for even an obvious question!

[Skylark]

It's not obvious at all. I understand it because I have run ELISA assays, plus I read a paper on how even low-normal IgA can make TTG testing unreliable. I like to help, like everyone around here, and I actually knew the answer to that one.

[IrishHeart]

I nominate this for the best answer to any question this week, succinct, but easy to understand !

ditto

yaayy Skylark!