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What are the findings from the child's blood test report?

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General & Family Physician
Practicing since : 2007
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My 4 year old son was diagnosed 3 months ago with celiac disease (blood test positive on all (IgG, IGA, etc.) and positive biopsy) and bad anemia. He has been gluten free and on iron supplements since his diagnosis. We had his blood retested last week (full CBC and celiac panel) and everything came back in the normal range except for the IgG test still showed a result of 10 (high)...but the IgA was negative this time (<2)....and his RDW was High (18.3%)...and although his TIBC was normal range (371), UIBC was normal range (346), Iron Serum was normal range (25), his Iron Saturation as only 7% (LOW). I see his doctor next week - but am anxious to understand what it he still anemic even though his other iron levels are normal now? Or does Iron Saturation just take more time to come up? Why is his RDW high (18.3%) and his IgG positive (although much lower then it was) even though he has been gluten free? Thanks!
Posted Fri, 14 Feb 2014 in General Health
Answered by Dr. Lohit K 28 hours later
Brief Answer: Iron defeciency anemia.No worry for IgG & RDW Detailed Answer: Hi, Thanks for using XXXXXXX I went through the query and understood your concern. * High IgG suggest past history while IgM, IgA suggest the present situation. Since IgA(more specific for celiac disease) was negative no need to worry for now about high IgG as this will return to normal in time. * Increased RDW suggest increase numbers of immature red blood cells (reticulocytes) due to regenerative response to an anemia, because immature anucleate red blood cells are larger than normal. So I the high RDW is a good response to anemia. *Low iron saturation suggest iron defeciency anemia. Once iron gets absorbed by the intestines, it is transported to other locations with the help of a blood protein called transferrin. Iron saturation is calculated by dividing the level of serum iron by the total iron binding capacity (TIBC) and multiplying by 100. The percentage tells how much of the serum iron is actually bound to the available transferrin. So low iron saturation suggests decreased iron absorption from the intestine which is common in celiac disease. So the saturation level comes to normal with time with increasing the iron absorption as it increases the serum iron level. With the oral supplementation of iron, it the Hb level does not increase, then your son may require parenteral(injection) iron therapy to improve his anemia status. Hope this information helps you. Feel free to ask if any related query and I will be glad to answer them. Wish you and your son a good health and faster recovery. Regards
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