My two year, nine month, son was diagnosed with type 1 diabetes eight months ago, and recently was screened for celiac disease, even though he has no symptoms. His antibody test results are as follows: anti-gliadian – 71 (normal less than 20) and IgA – 7 (normal less than 20). We will be seeing a pediatric gastroenterologist, but there is a long wait. Since one of the antibodies is negative, is this still a positive test for celiac disease? I’m confused by the conflicting test results.

The antigliadin test is not very specific and is less and less used for the diagnosis of celiac disease. In the absence of symptoms, I would ignore it. However, you do need to ask your son’s diabetes doctor exactly what the IgA test represented. I assume that this was either for anti-endomyseal antibodies or anti-transglutaminase antibodies, both of which are IgA’s. Depending on the laboratory, the level of anti-transglutaminase antibodies can be used to predict damage to jejunal mucosa, and thus, in large measure, dispense with the need for a biopsy before deciding the need for a gluten free (wheat free) diet. I suspect though that either your diabetes team or the gastroenterologist will want to repeat the anti-transglutaminase test at intervals just as they probably will test for hypothyroidism.

DOB