IgA deficiency?

[Nome11]

I recently posted on here about my son who had a severe facial rash, and had many helpful replies. I'm now hoping someone can help with some test results.

Long story short I've had bowel troubles for around 14 years, and have tested negative for coeliac twice in the past year. My IgA TTG came back as <1 and my GP surgery doesn't check for IgA deficiency. I queried this after cutting down on bread and feeling a lot better (not completely, but I was still eating things like pasta etc). The GP was very nice and said he would check for IgA deficiency but he was basically doing it to give me some closure.

I accessed my results on the NHS app this morning so haven't officially heard back, but my IgA is lower than normal, but still present. Is this something that could cause a false negative?

Thanks so much.

[Researchfan]

It’s hard to say for certain. The next step would be to consult your GP. Get them to request the Coeliac Screen blood test with a check for total igA included. Most labs in the UK will test this so it’s surprising your GP hasn’t. If igA low the lab will automatically (usually for most labs anyway), test for the IgG TTG. If this is high similar to the igA TTG test suggestive of Coeliac Disease. But not conclusive (unless 10x the upper value). Though rare a few transient conditions can turn an antiTTG test positive. Crohns Disease, other enteropathies caused by cows milk and soya protein, Type 1 diabetes and rheumatoid arthritis to name some.

It’s important to remember that there are many conditions can affect the gastrointestinal tract. With very similar symptoms to Coeliac Disease. It is the one mostly known about today and if you’ve got a relative with it it’s possible. But the only way to be certain is for the gut biopsy. Or to have it completely ruled out with a genetic test.

Make sure you’re still consuming gluten foods before another test.

If you struggle to eat conventional bread (can sympathise). My Dietician advised when I did gluten challenge to have barley water, rye crackers, soups with pearl barley, sourdough spelt bread that kind of foods. Or maybe try unleavened bread in case it’s a yeast sensitivity.

Hope that’s a helpful reply.

[Nome11 in reply to Researchfan]

Yes, thanks very much. No one in my family has a diagnosis of coeliac but I strongly suspect my mother has it - she has autoimmune hypothyroidism and has had constipation etc since early childhood. She refuses to get tested for coeliac. My grandmother had PBC which is a rare autoimmune liver disease, with a higher incidence of CD than the general population. My stool samples came back clear so very unlikely to be inflammatory bowel disease. The GP seemed surprised at my suggestion of testing for IgA deficiency because the TTG IgA is so reliable (even though NICE guidelines say IgA deficiency should be tested for). I'm going to speak to the surgery on Monday so hopefully take it from there.