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

IgA DEFICIENCY    


      IgA deficiency has impact on the celiac panel of tests that are based
on the IgA factor, including the most specific and sensitive tTG-IgA test
for celiac disease.  IgA deficiency may be a potential source of
false-negative results on tests for IgA antibodies.   Most labs do the
tTG-IgA.  However, if the patient has had the Total Serum IgA test and is
found to be IgA deficient, the lab should do a tTG-IgG test.  Initially,
therefore, the doctor should order a Total Serum IgA test plus a tTG and
mandate that if the patient is IgA deficient, do the tTG-IgG test. IgA
deficiency will show as a low number, although all labs have differing
ranges.

      Dr. Sheila Crowe (former physician advisor for our chapter) says,
"Total IgA levels are within a certain normal range (varies with the lab)
and typically less than 60 is low. With good laboratories, the tTG IgA level
is reported as an actual value and if that value is very low that would
suggest IgA deficiency. For example, less than 20 is normal at our lab, but
if a tTG IgA comes back at a value of 0 or 1, one should be concerned about
IgA deficiency. The current recommendation is to just screen with tTG IgA
and then check total IgA level if the tTG IgA level is very low. The problem
is that some labs like LabCorp report normal as less than 5 but don't give
an actual value. The options when IgA tTG levels are low are to either go
straight to EGD with biopsy if the index of suspicion is high, or check tTG-
IgG."  Dr. Crowe is an Associate Professor in the Division of
Gastroenterology and Hepatology in the Department of Internal Medicine at
the University of Virginia. 

-- Janet Rinehart, Chairman, Houston Celiac Support Group,
www.houstonceliacs.org

 

 

 

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