Low Iga, Possible Celiacs In 4 Year Old?

[jomakamcki]

Hello All! I am new here, just found this site today. I'm hoping the parents here with Celiac experience might be able to help me a little. I took my 4 year old daughter to the doctor because of constant stomach pains, random vomiting (no one else in the house gets sick) and diarrhea. This has been going on and off since she was about one, but has drastically become worse over the past couple of months. My pediatrician ran some blood work and suggested we see a pediatric GI. We saw him yesterday. After explaining her symptoms and an exam, he is a little concerned she might have Celiacs. I questioned him, saying that the labs were all negative for Celiacs. He said yes they were, but that her IgA level was low and with a low IgA it can affect the other results. Naturally { }, I came home and googled IgA levels. They gave me two different numbers, her IgA is 2 (normal for her age is 1-19, so low but still in range), and her IgA serum is 53 (normal for her age 61-345, also low, but not terribly) Her IgM was also on the low end of normal at 0.1 (normal range being 0-0.8). When I googled these numbers it didn't seem like the numbers I was given even fit into the ranges I find online, maybe different amounts, grams/miligrams, for example? I guess my question is this, with her symptoms, and her IgA levels, what is the likelyhood we could be looking at Celiacs? I don't want to stress and worry if I don't need to, but want to be prepared for our next GI visit as well. I know there are some genetics involved, so just FYI my father (her grandfather) has a gluten allergy, but not celiacs, and her paternal grandmother has a sister (so my daughters great aunt) with Celiacs. Thank you for any insite you might have or any info you can give.

[beachbirdie]

Hello All! I am new here, just found this site today. I'm hoping the parents here with Celiac experience might be able to help me a little. I took my 4 year old daughter to the doctor because of constant stomach pains, random vomiting (no one else in the house gets sick) and diarrhea. This has been going on and off since she was about one, but has drastically become worse over the past couple of months. My pediatrician ran some blood work and suggested we see a pediatric GI. We saw him yesterday. After explaining her symptoms and an exam, he is a little concerned she might have Celiacs. I questioned him, saying that the labs were all negative for Celiacs. He said yes they were, but that her IgA level was low and with a low IgA it can affect the other results. Naturally { }, I came home and googled IgA levels. They gave me two different numbers, her IgA is 2 (normal for her age is 1-19, so low but still in range), and her IgA serum is 53 (normal for her age 61-345, also low, but not terribly) Her IgM was also on the low end of normal at 0.1 (normal range being 0-0.8). When I googled these numbers it didn't seem like the numbers I was given even fit into the ranges I find online, maybe different amounts, grams/miligrams, for example? I guess my question is this, with her symptoms, and her IgA levels, what is the likelyhood we could be looking at Celiacs? I don't want to stress and worry if I don't need to, but want to be prepared for our next GI visit as well. I know there are some genetics involved, so just FYI my father (her grandfather) has a gluten allergy, but not celiacs, and her paternal grandmother has a sister (so my daughters great aunt) with Celiacs. Thank you for any insite you might have or any info you can give.

Welcome to the board. You will get lots of good advice here, best place around!

It looks like they only did an IgA version of the celiac test, so those tests don't necessarily rule out celiac. The serum IgA is a test they do just to see how many of the IgA class antibodies there are, it isn't a test specific for any disease. If it is very low, as in the case of your daughter, they can't use results of celiac tests based on IgA.

They need to do IgG versions of the tests.

You should be looking for Deamidated Gliadin Peptides IgG, and Tissue Transglutaminase IgG (also written as DGP IgG and TtG IgG). They should also run anti-EMA, but that is going to be an IgA test unless they specify they want an IgG version, which is almost never done. If your isurance will go for it, it might be worth getting the genetic tests done.

They also might recommend a biopsy if there are enough symptoms to warrant.

It is very common for children to be low in IgA, it is also very common for low IgA in celiacs. Yes, you could definitely be looking at celiac here.

Did they test for any nutritional deficiencies? B12, D₃ and iron (anemia) are very common with celiac.

As for the different kinds of numbers you found when Googling, you will see a lot of differing lab ranges as you read. Every lab has its own set of ranges, so it's always important to include the range with lab information you might post. Also important not to infer anything from your own results when comparing with numbers you see online. You'll comparing apples to doughnuts. Read your results against your own lab's range as given with each particular blood draw.

Did the new GI make any suggestions or discuss a plan for future testing? Did he draw any more blood?

Don't stress. The good thing about this not-so-wonderful condition is that once you know you have it, you're in control. You don't need prescriptions and you don't need permission to eat gluten free!

[jomakamcki]

Thank you for your reply. In my original post I included the ranges I was given at my doctors office. The only one that was under the normal range was my daughters serum IgA, the others were just on the very low end of normal. I'm not sure if any other tests specific to Celiacs were done or not, those are the only numbers the GI gave me in regards to the possibility of Celiacs.

As far as treatment, right now he put her on 15mg of Prevacid. He wants to try that for 30 days and see if there is any improvement. We see him on August 20th and he will decide at that time if he thinks it would be wise to scope her. He told me not to do anything with reducing gluten at this point because if we did then the scope might not be accurate anyway.

Looking at symptoms of Celiacs, my daughter doesn't really seem to fit, at least in my opinion. She is very tall for her age (95th%), and average for weight (50th%). She has never has problems with gaining weight or thriving. Her symptoms are chronic/daily stomach pain, and occasional (more often than most people, but not daily) vomiting or diarrhea. Do low IgA levels indicate Celiacs, or does that just mean the bloodwork might not be accurate? I would hate to put her through a scope if it isn't very likely this is what she has.

I guess we will just have to wait and see. I was hoping to go into the next GI visit with a little knowledge of Celiacs, but as I look into things it is more confusing than helpful.

Thanks again!

[Cara in Boston]

You have celiac disease in the family and your daughter has very clear symptoms. You are so lucky to have a doctor that sounds like he actually knows a little something about it (blood tests can be falsely negative, continue eating gluten until testing is done, etc.)

My son had ZERO symptoms until we noticed a sudden change in behavior. He was taller than average, never sick, never any GI issues, nothing. All his IgA tests were normal and he was not deficient. Luckily, they ran a complete panel that included the IgG tests. Those were elevated. Our first doctor said he couldn't possibly have celiac disease because his IgA tests were normal and he was perfectly healthy - no issues other than behavior. We took him to a specialist at a different hospital and they found extensive celiac damage when they did an endoscopy.

We had no known family history of celiac disease, but I had been suffering from all the "classic" symptoms for about 5 years. When I started researching it for my son, a lightbulb went off. My blood tested positive and we have both been happily gluten free since then.

Now, if he gets accidently glutened, we see other, more "classic" symptoms (and again with the crazy bad behavior), but really, he did not look like a kid with celiac at the time of diagnosis.

I'd bet your daughter is - at the very least - gluten intolerant.

We saw so many other improvements once he was gluten free - things I didn't even know were related. He sleeps better, more consistent good mood, just happy and full of energy. Before we would describe him as our grouchy couch potato. In retrospect, he just didn't feel good all the time. Poor kid!

Cara

[jomakamcki]

@Cara...Celiacs can affect behavior?! I've never really looked into Celiacs, until the last few days I never had any reason to. That would explain a lot for my daugther! She is very active, but she is definitely extremely moody. I've always said she went from "terrible twos" to "treacherous threes". Now that she is 4 (turned 4 in May) I was hoping to see some improvement. Hmm...makes me wonder! I will have to read up on all the ways celiacs can affect kids, maybe she has more symptoms than I realized.

Very interesting! Thank you so very much for your insight and experience!

[Cara in Boston]

I bet you will see a HUGE improvement in behavior once you are able to get her gluten free. I was amazed. It makes it so much easier to be very, very strict with the diet when you see how much even a little gluten effects so many different things.

Good luck -

Cara

[Mom2J112903]

*ANY* allergy/intolerance/disease/disorder process can and *will* affect behavior. If your body doesn't get what it needs and is attacking itself (as in the form of Celiac or any other autoimmune disorder) you are going to fell *awful*! My son, wow, we didn't realize what a personality he has until he got his g-tube (numerous GI disorders) and what the proper nutrition can *really* do for a body AND the mind.