Blood Test - Help With Results

[C.H.]

Hello,

I need your help with my wife´s blood test. First of all, I like to thank for this amazing forum, I´ve learned a lot about celiac disease. And apologize because my english is not good.

Backing to the problem, my wife´s mother has C.D and she asked to my wife to do the blood test to check if her has too. But here, in Brazil, this disease isn´t very known by the people, and the doctors are included. So, i would like some help to interpret the test.

The result of blood test is following:

Total Serum IgA - 208,00 mg/dL (normal)

Anti-Tissue Transglutaminase IgA and IgG 54 EliA U/mL(reactive)and 0,0 U/mL(not reactive)

Anti-Endomysial IgA and IgG 1/20(not reactive)and 0 (not reactive)

And she don't have symptoms. So, what do you think? She will do the endoscopy and biopsy, but I´d like some help to interpret this result.

Thanks for the help again!!

[plumbago]

CH,

Hopefully other people will reply, besides me.

Here's what I can tell you so far - first of all, it seems (to me at least) that the doctor did some good tests. The anti-endomysial tests are among the most sensitive and the most specific.

Regarding this test (anti-endomysial), these are some notes I compiled recently:

EMA stands for antiendomysial antibodies, which are antibodies produced by the body that attack the body's own tissue. when the EMA-IgA is positive, the patient almost certainly has celiac disease. However, the test also can produce false negative results in patients with celiac disease but only partial villous atrophy.

Highly specific, and 90% sensitive. The EMA antibodies correlate to degree of villous atrophy. Observer-dependent."

The total serum IgA levels means your wife is not IgA-deficient. This is important to establish prior to doing testing for these anti-bodies. It's not necessarily a part of the celiac blood test, though (again, from what I understand). In other words, the results of your wife's total serum IgA level does not really say anything about whether or not she has celiac disease.

From looking at the results, it appears that the only positive result that might be suggestive of celiac disease is the tTG-IgA, right? If that is the case, then, me personally, I would do more blood tests before getting an endoscopy.

Also - this is very important: your wife must be eating her normal diet up to the date of the blood test, which would include gluten in order to get an accurate reading. One should not stop eating gluten before getting the blood tests.

I was in Brazil for the first time about two years ago. I must say that gluten (or wheat in general) did not seem to be such a heavy part of the diet as it is here in the USA.

Please let me know if there is anything that I was not clear about. And again, there are some REAL experts here in reading the blood tests. Hopefully you will hear from them soon.

Plumbago

[nvsmom]

It looks like your wife has a positive anti-tissue transglutamase IgA (TTG IgA) test but I'm not sure because the reference range was not given. Did the lab tell what the "normal ranges" were that they compared your wife's results with? For example, a patient might have a result of 34 on a test; if the reference range is 0-20 then it is positive but if the range is 0-40 then it is not positive. Knowing the reference range makes it easier to interpret the results.

If her TTG IgA is positive (I assume that is what reactive means?) then she probably has celiac disease, but other intestinal infections or disorders can sometimes cause that result too... but it is not common.

There are many celiac patients who have no symptoms, or mild symptoms so do not rule out celiac disease as a possibility based on that. There is a strong genetic link so if her mother has it, she is more likely to have it than a person outside of their family would be.

I wish her luck on the endoscopy. Make sure she does not stop eating gluten before the test. Best wishes to you both.