<<Disclaimer: Verify this information before applying it to your situation.>>

> Could someone please explain the significance of the following test
> results. Results pertain to a family member, diagnosed with CD about 9
> months ago, who has been following a GF diet.
> RETICULIN IGA, ENDOMYSIAL IGA, GLIADIN IGG = NONE DETECTED
> GLIADIN IGG = 14 EIA UNITS (REF RANGE =(<10, 10 TO 15 = INDETERMINATE)
> GLIADIN IGG AB APPROXIMATE 100% SENSITIVITY FOR CD IN CHILDREN AND ARE 45 TO
> 85% SENSITIVE FOR DEMATITIS HERPTIFORMIS.
> GLIADIN IGA AB ARE NORE SPECIFIC BUT LESS SENSITIVE THAN IGG GLIADIN AB FOR
> CD.

This question seems like it would be of general interest to people on this
list so I will respond to the list instead of individually.

IgA class Reticulin antibodies are found only in Celiac disease and
dermatitis herpetiformis.  These antibodies are found in approximately 60%
of CD patients and 25% of DH patients.  This test is falling into disuse
because of the limited utility and the availability of better tests.

IgA class endomysial antibodies are very specific, occuring only in CD and
DH.  These antibodies are found in approximately 80% of patient with DH and
in essentially 100% of patients with active CD.  IgA endomysial antibodies
are more sensitive and specific than either reticulin or gliadin antibodies
for diagnosis of CD.  Antibody titers are found to parellel morphological
changes in the jejunum and can also reflect compliance with gluten-free
diets.  Titers decrease or become negative in patients on gluten free diets
and reappear upon gluten challenge.

The purpose of testing for anti-gliadin antibodies includes, in addition to
diagnosis of gluten sensitive enteropathy, monitoring for compliance to a
gluten free diet.  IgA gliadin antibodies increase rapidly in response to
gluten in the diet and decrease rapidly when gluten is absent from the
diet.  The IgA anti-gliadin antibodies can totally disappear in 2-6 months
on a gluten free diet, so they are useful as a diet control.  By contrast,
IgG anti-gliadin antibodies need a long time, sometimes more than a year,
to become negative.

The reverse is also true.  That is, a patient with CD who has been on a
gluten free diet and tests negative for IgA anti-gliadin antibodies, will
show a rapid increase in antibody production when challenged by gluten in
the diet.  Approximately 90% of challenged patients will yield a positive
IgA anti-gliadin result within 14-35 days after being challenged.

The test results you reported are consistent with a patient who is
conforming to a gluten free diet.