2-3xN] serum anti-tTG antibodies; and d) subjects with a family history of CD. Possible false-positive tTG result Celiac disease possible but unlikely If strong suspicion of celiac disease remains, perform HLA typing. If tTG-IgA and/or DGP-IgG is positive, irrespective of titre, refer for confirmatory small intestinal biopsy MBS item number 71163, single antibody test ($24.75). Weak positive Selective IgA Deficiency . If the level is normal, tTG-IgA is measured. with weakly positive [e.g. The Endomysial Antibody test (EMA) is an earlier version of the tTG test. Now you need the rest of the workup to confirm but the weak positive should spur your doctor to do the EGD and TTG IgA Deaminated tests too. Abdominal Pain/GI symptoms started= ~01/02/2014 1 CELI / Celiac Associated HLA-DQ Alpha 1 and DQ Beta 1 DNA Typing, Blood Not celiac disease Possible celiac disease Celiac This is because TTG IgA levels will not rise if one has both celiac disease and a serum IgA deficiency (as described above). It is not as widely available as tTG and is more expensive than tTG Serum TTG-IgA antibodies are positive in approximately 95% of celiacs who are on gluten-containing diets. n=69,577 (97.5%) n=1532 (2.1%) n=270 (0.4%) Tissue transglutaminase antibodies (tTG IgA and tTG IgG): tTG IgA is recommended as a first-line marker for CD, 4 with a sensitivity of 95% to 98% and a specificity of 94% to 95%. However, if the tTG-IgG alone is positive, and the patient does not have IgA deficiency, then the tTG-IgG test is rather inaccurate. Conversely, IgA tTG is more accurate than IgA DGP. The finding of transglutaminase IgG antibodies may indicate a diagnosis of celiac disease, particularly in individuals who are IgA deficient. 1 tTG IgG has a lower sensitivity (40%) for CD, but is also highly specific (95%). IgA and IgG Anti-TTG, IgG Anti-deamidated gliadin, IgG Anti-TTG, IgA and/or IgG Anti-deamidated gliadin, IgA and IgG Interpretive comments Interpretive report includes: Immunoglobulin A (IgA) Endomysial antibodies, IgA . IgA 4-10 u/mL: Weak Positive IgA 11 u/mL or greater: Positive Presence of the tissue transglutaminase (tTG) IgA antibody is associated with glutensensitive enteropathies such as celiac disease and dermatitis herpetiformis. A positive tTG test is indicative of celiac disease. Some laboratories have designed a cascade of tests that starts with the total IgA measurement. 3. However, celiac disease blood testing should always include a TTG IgA as well as a serum IgA. test for total immunological immunoglobin A (IgA) and IgA tissue transglutaminase as a first choice test use IgA endomysial antibodies (EMA) if IgA tTG is weakly positive consider using IgG EMA, IgG deamidated gliadin peptide (DGP) or IgG tTG in cases of IgA deficiency. If the total IgA is low, then both tTG-IgA and tTG-IgG are measured. A positive IgA tTG result should prompt small bowel biopsy with at least four tissue samples to confirm the diagnosis. You doctor is recommending a biopsy to confirm that diagnosis. - patients with IgA deficiency, type 1 diabetes, inflammatory bowel diseases (Crohn's disease or ulcerative colitis), Helicobacter pylori infection There is also an IgG tTG test but it is less accurate than the IgG DGP test. Option 2: Transglutaminase-IgA (tTG-IgA) + Total IgA level If the IgA level is low, perform the deamidated gliadin peptide-IgG (DGP-IgG). Safe to say weak positive is positive. Even if the biopsy comes out negative, there has to be a reason the tissue of your daughter's small intestine is being destroyed. However, 3 percent of negative . For individuals with moderately to strongly positive results, a diagnosis of celiac disease is possible and the patient should undergo a biopsy to confirm the diagnosis.