Positive IgA Anti-Gliadin antibodies

I do not think I have typical symptoms of celiac disease.  However, I do have occasional, unexplained post prandial diarrhea (usually after lunch), & bloating in the evenings.  I have autoimmune thyroiditis (hypo) and take levoxyl.  I had a full battery of testing done because I have had recurrent (over a year) oral blisters that started out fairly painless and small but have now become more painful.  They range from 1-5mm in size and last up to 24 hours.  They then burst and become a shallow ulcer that heals relatively quickly (especially the smaller ones).  I get these on the buccal mucosa primarily but have had some changes on the gingiva (white patches) and the hard palate (ulcerations, petechiae).  I also have a long history of geographic tongue but now have lost ~25% of the taste buds on one side of  my tongue.

The testing I had included blood work for vitamin deficiencies, anemia, and a celiac profile.  All was fine except the IgA anti gliadin antibodies was 26 (normal <11).  Total IgA and the Tissue Transglutaminase IgA were normal.

My husband spoke to a gastroenterologist friend who said "not to worry, it's not celiac disease".  What causes anti gliadin antibodies??  Should I pursue any further evaluation?

Thanks.  I am 46 years old and have no family history of celiac disease.

[Kevin Pho, MD]

IgA antigliadin antibodies are not the most sensitive tests for celiac disease, as other diseases, such as allergic-related conditions, can raise these levels as well.

If celiac disease continues to be a concern, an endomysial IgA antibody should be obtained, and depending on the clinical suspicion, a small bowel biopsy discussed.

If the diarrhea or loose bowel movements continue, a colonoscopy as well as sending the stool off for analysis and culture can be discussed.  

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin Pho, M.D.
www.kevinmd.com
www.twitter.com/kevinmd

[beansmomma]

I forgot to mention that I am also lactose intolerant for the past 10 years.

[CalGal]

Beansmomma, you may want to consider checking to see if you're carrying the (genetic) alleles that predispose you to celiac issues. If you carry the genes and you're having a positive antibody test, you could be celiac. Also consider being tested for 'cross-reactivity' to casein. It's a major protein in dairy and many celiacs find they generate antibodies to the protein. It's possible you may not be lactose intolerant, but may actually be reacting to the protein.

Many celiacs don't have what could be considered 'normal' symptoms - my husband was one of those.