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Ask the Doc: Can IgA level affect celiac testing?

Posted on December 11th, 2008 by Alison Read 4 Comments - Add Your Own »

questionmarkgreen1.jpg Q. Is it common for kids (my son is 2.5) to have false negatives? How much does his IgA level affect the testing? My son has never had growth issues, is it still possible for his symptoms to be caused by Celiac? Can Celiac be jump started by rota-virus? Can the testing be misread?

Sorry for all the questions, but my son (2.5) has had chronic diarrhea, as well as many other issues, since he was hospitalized with rotavirus. After 2 endoscopes the cause of his problems is still undiagnosed. He is IgA deficient, but nobody has mentioned much about that, but I have read that can affect the testing.

A. Since the tTG antibody test is an IGA antibody, IgA deficiency will make the tests falsely negative. An IgG tTG test would be helpful, as would HLA DQ2, DQ8 genetic studies. If any of those are positive, he needs an intestinal biopsy. He may well have post-infectious irritable bowel syndrome, especially if there was stress at the time of the initial rotavirus infection. Very low doses of aminosalicylates such as balsalazide (use about 250mg in applesauce) daily could help.

Health and happiness,
Dr. Aron

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  1. My 14 yr. old daughter tested negative for celiac blood test. My 16 yr old
    son tested positive. Both no longer seem to be growing (their heights are
    4′ 9 1/2″ (girl), and 5′ 3 1/2 (boy) Both tested normal for growth hormones yrs. ago.
    I am 5′ and my husband is close to 5′ 8′.My son is obese and everyone else
    is normal weight. My son also has ADD. My daughter has no other symptoms.
    Should I assume she is not celiac?
    Risa Johnson

  2. Well, you can assume she’s fine, and let things go, or you can simply serve her the same food as you will be giving your now gluten-free son. Me personally, I’d err on the side of caution, and try her on the GF diet. The biggest problem without a conventionally confirmed diagnosis is longterm compliance. If you think she would try the diet and stick with it if she feels good on it, then you have nothing to lose. If she’s the type to need proof before she believes in it, then you could re-test her later. She may be IgA deficient, too, though, so that would skew her results. Just because she’s not intestinally symptomatic doesn’t mean she isn’t reactive — she could have damage to other organ systems that would take longer to manifest. Things like diabetes, infertility, thyroid problems, etc are also higher in undiagnosed Celiacs. The slight stature is also more prevalent in Celiacs.

    Whatever you decide, your children are blessed to have such a concerned and careful parent!

  3. Thank you Rebekah.

  4. My daughters blood test was negative, but due to constant stomach pain doctor ordered biopsy and genetic test which both showed celiac – its possible for some celiacs not to show it in their blood test doctor said. We also today found out she has low bone density (due to celiac) She is almost 14 and had time to repair bone, but I’d agree and say put her gluten free to be safe – or press for further testing.

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