Q & AReturn to ->Ask the Doctor->Tests and Their Results QUESTION: Our 12 year old son was diagnosed with celiac on November 30, 2006, after not railing from an acute stomach virus that occured in early October. At the time of his diagnosis, his tTg was >100 and a biopsy showed complete atrophy of his villi. Since then we have had several blood tests, because, even though we have a strict gf diet, he is not really progressing. So our blood work has looked like this: had test in early January, results were tTg >250 and EMA at a titer of 1:80. In February his results were tTg 70.2 and EMA 1:20 and now i March his tTg is 34.5 and his EMA is back up to 1:80. FYI: All blood tests, except the initial one, were done at the same lab. We are optomistic that the trend for the tTg indicates that he is healing. However, what would you make of the EMA going back up? Does it indicate gluten contamination? Just slow progression? Observer error? His primary symptom is intense abdominal pain, and very slow, if no, peristaltic motion. He is really struggling, so knowing if this is something we should be concerned with, or should just be patient with, would really be helpful. Thanks for your time.
| | DR. LEWIS: I would tend to be reassured that the falling titer for the anti-tissue transglutaminase antibody means he is healing. EMA is a more complicated test and can have significant variablitiy depending on who is performing the test. If your son still has symptoms, it would be worthwhile to meet with a very experienced nutritionist to review all of his intake for signs of gluten. It can take a year or more for a high ttg to normalize. |
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