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scamelo
Joined: 12 Apr 2008
Posts: 2
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 Posted: Sat Apr 12, 2008 11:29 am Post subject: 15 Year old with chronic stomach pain |
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New to this board, hoping to get some help
Long story, trying to shorten it.
My 15 YO has had severe stomach pains for over 2 months. The pain is in the upper abdomen area, sort of between the ribs. When we first started it was just constipation she had, which has been resolved. No one was looking or thinking celiac when she had her tests.
So far Xray, CT scan and endoscopy and colonosocopy all normal, except for Barrett's esophagus, which is an issue, but would not be causing this pain. The pain is constant, and occasionally worse, but does not seem to depend on food right now.
She has not been in school for 2 months. Dr's now all say it is anxiety. She wakes up with this and goes to bed with this. Has it night and day and on weekends.
She does have some anxiety issues, was on prozac and is now trying wellbutrin.
Well I just requested a copy of her bloodwork, done by gastro. Over the phone I was told it was normal by office staff.
However I just need to ask you experts what your thought are on the blood work for celiac/gluten intolerance. It is so confusing
Test done at prometheus labs
+++++++++++++++++++++++++++++++++++++++++++++++
There is a box labled AGA IgG with a positive (+) in it in that box. The other three have a negative (-) for AGA IgA, TTG IgA, EMA IgA.
In summary interpretation box it says " Results may support a diagnosis io Celiac disease, but are not specific"
Below that it says IgG serological marker for celiac disease detected.
Below that it says AGA IgG Evaluations with IgA deficiency indicated that celiac disease is probable. AgA IgG evaluations with normal IgA occur in normal individualw as well as other GI conditions. HLA typing may be helpful
Then come the actual numbers
Anti-Giladin IgG GElisa ( AGA IgG) 18.6 (result) <10.0 Range
Anti-Gildadin IgA Elisa ( AGA IGA) 0.9 ( result) <5 range
Anti-Human Tiss Transglutaminase IgA Elisa TTG IgA 0.3(value) <4 range
Anti-endomysial IgA IFA Negative
Total Serum IgA by Nephalometry ( total IgA) 141 range 44-441
This came via fax, so bare with any misspellings.
My hubby and I are stumped as to what this means. Gastro is away until thursday, but office said she was normal.
Can she be gluten sensitive or just have other gastro issues if its only AGA IgG that is high?
Thanks for any help! |
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cruelshoes
Joined: 23 Sep 2005
Posts: 2542
Location: Washington State
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| Posted: Sat Apr 12, 2008 1:31 pm Post subject: |
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scamelo - I am really sorry you DD is having trouble. The teenage years are hard enough without all of this going on. I am going to give you some information that may be of help. It may be too much, but that's just how I roll.  Keep in mind that none of us are doctors, so definitely follow up with your GI.
First some information on the IgG antibodies:
http://www.americanceliac.org/diagnosis.htm
| Quote: | What are the different antibody tests available? Can there be errors in testing?
The blood tests can be divided into 2 different types of antibodies: those which are “anti-gluten”, and those that “anti-self”. The “anti-gluten” antibodies are the anti-gliadin IgG and IgA. Ig stands for “immunoglobulin” or “antibody”. The “anti-self” antibodies are anti-endomysial IgA and anti-tissue transglutaminase IgA.
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Antigliadin antibodies
The antigliadin antibodies IgG and IgA recognize a small piece of the gluten protein called gliadin. These antibodies became available during the late 1970’s and were the first step towards recognizing CELIAC DISEASE as an autoimmune disorder. Antigliadin IgG has good sensitivity, while antigliadin IgA has good specificity, and therefore their combined use provided the first reliable screening test for CELIAC DISEASE. |
The IgG test is highly sensitive, but is less specific to celiac disease.
http://www.celiacdiseasecenter.columbia.edu/C_Doctors/C05-Testing.htm
| Quote: | Causes of false positive celiac serologic tests
The endomysial antibody test is virtually 100% specific for celiac disease. However anti-tTG has been reported to be positive in the presence of liver disease, especially cirrhosis [33], diabetes [34, 35] and severe heart failure [36], as well as arthritis [37] and various autoimmune disorders [38]. The use of human tTG as the antigen in the test kit adds some greater specificity. Antigliadin antibodies may be present in inflammatory bowel disease [39], collagen vascular disease [40], and in many healthy people as well [41]. |
This link is a little older, but does have some relevant portions.
http://www.celiac.com/articles/57/1/Interpretation-of-Celiac-Disease-Blood-Test-Results/Page1.html
| Quote: | Anti-Gliadin Antibodies:
Both IgA and IgG anti-gliadin antibodies (AGA) are detected in sera of patients with gluten sensitive enteropathy (celiac disease). IgG anti-gliadin antibodies are more sensitive but are less specific markers for disease compared with IgA class antibodies. IgA anti-gliadin antibodies are less sensitive but are more specific. In clinical trials, the IgA antibodies have a specificity of 97% but the sensitivity is only 71%. That means that, if a patient is IgA positive, there is a 97% probability that they have celiac disease. Conversely, if the patient is IgA negative, there is only a 71% probability that the patient is truly negative for celiac disease. Therefore, a positive result is a strong indication that the patient has the disease but a negative result does not necessarily mean that they don not have it. False positive results are rather uncommon but false negative results can occur. On the other hand, the IgG anti-gliadin antibodies are 91% specific and have an 87% sensitivity. This means that they will show positive results more readily but there is not as strong a correlation with celiac disease. It is less specific. Patients with other conditions but not afflicted with celiac disease will occasionally show positive results. IgG anti-gliadin antibodies are detectable in approximately 21% of patients with other gastrointestinal disorders. This test might yield false positive results but is less likely to yield false negative results. |
So what does this all mean to you and your daughter? The tests are not confirming that she is producing celiac antibodies. A GI will be unlikely to diagnose celiac based on the values posted above. But she could still be producing antibodies to gluten. The IgG may be telling you that. She could have non-celiac gluten sensitivity, or she might have something else. There are those on the board that have never had a positive test result yet they experience relief from their symptoms when they remove gluten from their diets. I think you have nothing to lose and everything to gain by trying her on a GF diet for a while. If she is willing to give it a try, you might be surprised by what you see. But you would have to commit to it 100% with no cheating, or it will be harder to tell if it is having any effect.
I hope this has helped and not made things more confusing
_________________
-Colleen
Dx 8/05 via bloodwork/biopsy
10-YO son Dx 11/05 via bloodwork/biopsy
Daughters (12 and 2) have neg. bloodwork
A woman is like a tea bag-you never know how strong she is until she gets in hot water. - Eleanor Roosevelt |
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scamelo
Joined: 12 Apr 2008
Posts: 2
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| Posted: Sat Apr 12, 2008 3:02 pm Post subject: |
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Thanks so much for your reply. We are going to see if we can get her to eat gluten free even if only for a few weeks to see if this helps her.
I guess the IgG can be from anything, not just celiac or gluten, is how I understand it.
I really appreciate your help |
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