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Confused By Bloodwork & Gi's Uncertainty, But Endoscopy Next Week...
#1
Posted 05 April 2012 - 11:29 AM
He checked her iron, thyroid and TTG (for Celiac?). Everything came back fine except her TTG was 108. He said anything under 20 was normal, so he was quite certain she had Celiac just based on that. My husband's grandmother did have Celiac, but I wasn't aware it was hereditary so never mentioned that.
Anyway, the Ped referred us to a Pediatric GI. He re-did her TTG test and it came back at 79. That was maybe 3 or 4 weeks later. Does it seem strange that it would go down by almost 30 points? We didn't have her on any sort of gluten-free diet, although she generally prefers rice, eggs, cheese over gluten foods anyway (but she does eat crackers and pasta a few times a week). As far as I know, the TTG was the only Celiac bloodtest they ran.
We go for an endoscopy/biopsy next week, but the GI didn't really sound convinced that we would definitely be getting a positive diagnosis and that most of the cases they see are TTGs in the 200s.
Is it common to have a semi-high TTG, but a negative biopsy, and then it turns out not to be Celiac?
I have a feeling the biopsy will be negative and then we'll be back to square one.
Thanks for any input!
Mel
#2
Posted 05 April 2012 - 11:49 AM
TTG is an autoimmune antibody. It is most commonly caused by celiac (90% of the time) but it can also show up in inflammatory bowel disease, rheumatoid arthritis, and less commonly in other autoimmune diseases like autoimmune liver or thyroid disease. With the growth problems and lack of obvious gastro issues it's most likely celiac. I would want to ask for a specific celiac blood test like DGP-IgG or anti-EMA.
Amounts of antibodies can shift around. Sometimes your immune system is more active, sometimes less. My thyroid antibodies never come back exactly the same.
Even if the biopsy is negative I would still try taking her off gluten to see if she starts growing better and feeling better. False negative biopsies are possible when damage is patchy or the Dr. doesn't take a lot of samples.
#3
Posted 05 April 2012 - 12:09 PM
Hi and welcome to the board.
TTG is an autoimmune antibody. It is most commonly caused by celiac (90% of the time) but it can also show up in inflammatory bowel disease, rheumatoid arthritis, and less commonly in other autoimmune diseases like autoimmune liver or thyroid disease. With the growth problems and lack of obvious gastro issues it's most likely celiac. I would want to ask for a specific celiac blood test like DGP-IgG or anti-EMA.
Amounts of antibodies can shift around. Sometimes your immune system is more active, sometimes less. My thyroid antibodies never come back exactly the same.
Even if the biopsy is negative I would still try taking her off gluten to see if she starts growing better and feeling better. False negative biopsies are possible when damage is patchy or the Dr. doesn't take a lot of samples.
Thanks very much for the information. I guess if the biopsy is negative, I will ask for those other specific celiac blood tests. The GI said he would be taking 5 samples, so hopefully if there is damage he'll get the right spot.
#4
Posted 06 April 2012 - 04:38 AM
Again, don't assume she doesn't have it if the biopsy is negative. My blood tests were strongly positive and my biopsy was negative. My son has celiac (blood and biopsy) and all my symptoms vanished within weeks of being gluten free.
The doctor just thinks they didn't get a good sample (took 7 samples) or I just don't have any damage in my intestines YET. No reason to wait around for the damage to happen.
Cara
#5
Posted 06 April 2012 - 09:51 AM
She has symptoms, a family history, and a positive blood test. Even if the biopsy is negative, I would go gluten free as soon as the procedure is over. For peace of mind, have them take a blood sample for the additional tests at the same time as the endoscopy so you can go gluten free as soon as possible.
Again, don't assume she doesn't have it if the biopsy is negative. My blood tests were strongly positive and my biopsy was negative. My son has celiac (blood and biopsy) and all my symptoms vanished within weeks of being gluten free.
The doctor just thinks they didn't get a good sample (took 7 samples) or I just don't have any damage in my intestines YET. No reason to wait around for the damage to happen.
Cara
Although I doubt the GI will give a formal diagnosis with a negative biopsy, I'm pretty sure her pediatrician will recommend we try going gluten-free whatever the outcome, to see if it helps. My husband wants to go gluten-free regardless as we are at the point of trying anything if it will help her to be a happier little girl. That's great to hear you had such a positive experience going gluten-free. Will the doctor re-check your blood at some point? I would imagine if the levels went way down after being gluten-free for some time that would support a celiac diagnosis?
#6
Posted 07 April 2012 - 11:12 AM
Cara
#7
Posted 30 April 2012 - 10:18 AM
The next step is an appointment with a dietician. I'll be relying heavily on her help (and this forum). I need it.
I am happy in a way though, especially that her pediatrician thought to test for Celiac. Now I guess I should get my older daughter tested. She's the oppositive of my 4 year old though. My older daughter has boundless energy, very tall and athletic. However she has complained of bad stomach pains about every other day for the past year, so I guess it's worth looking into...
Thanks
#8
Posted 30 April 2012 - 10:36 AM
Once you figure out what changes need to be made, shopping gets easy again. We kind of buy the same stuff week after week so you won't be looking everything up after a while.
A year later it is really no big deal - really.
Everyone in the family needs to be tested. Don't put this off - once you start the diet, chances are everyone will be eating less gluten at home - get tested FIRST.
Come back here if you need suggestions for snacks and meals - everyone is really helpful.
Cara
#9
Posted 30 April 2012 - 10:42 AM
There's a lot of recipes and meal ideas on the board. You can absolutely learn to cook, and it's fun once you get the knack of it.
Cara's right about the grocery store seeming overwhelming at first. Try to shop around the outside of the store where the produce, meat, eggs, and dairy sections are are since that's where you find the naturally gluten-free food. Reading the labels on processed food can get pretty overwhelming. I'd recommend getting a rice cooker too. They are super-convenient.
#10
Posted 30 April 2012 - 10:47 AM
Thanks
#11
Posted 30 April 2012 - 10:53 AM
It's great they caught it so early! It can be hard to diagnose celiac in little kids. It does make sense to get your older daughter tested, especially since she will probably start eating less gluten now so the testing will be harder in the future.
There's a lot of recipes and meal ideas on the board. You can absolutely learn to cook, and it's fun once you get the knack of it.Some people find cooking shows on TV or YouTube helpful because you can see how food should look at various steps in the recipes. You could also see if there are local cooking classes.
Cara's right about the grocery store seeming overwhelming at first. Try to shop around the outside of the store where the produce, meat, eggs, and dairy sections are are since that's where you find the naturally gluten-free food. Reading the labels on processed food can get pretty overwhelming. I'd recommend getting a rice cooker too. They are super-convenient.
Thanks for the encouragement! I love the idea of taking a cooking class. I bet I might able to find a gluten-free one around here (I'm fortunate to live in a very health conscious city).
#12
Posted 30 April 2012 - 11:50 AM
#13
Posted 30 April 2012 - 11:59 AM
We have been gluten-free for almost 2 years now and I (personally) think it's one of the easier of out allergens to avoid!
Ask questions and you will get lots of help!
You'll rock this and think of it this way, it'll force you into becoming a better cook
#14
Posted 01 May 2012 - 08:56 AM
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