Jump to content

Follow Us:  Twitter Facebook RSS Feed            




   arrowShare this page:
   

   Get email alerts  Subscribe to FREE Celiac.com email alerts

 
Celiac.com Sponsor:                                    


Photo
- - - - -

Dgp Question....


  • Please log in to reply

4 replies to this topic

#1 roomorganizing

 
roomorganizing

    New Community Member

  • Advanced Members
  • Pip
  • 16 posts
 

Posted 29 January 2013 - 04:38 PM

We got results of my 12-yr-old daughter's blood work today. Everything was in the normal ranges except for the DGP, which was 37 units (<20 antibody not detected)(>or=20 antibody detected). Her CBC showed no abnormalities or deficiencies, so the doctor said he recommends eating gluten-free, but he will not diagnose her with celiac. He believes that she does not have full-blown celiac disease since there is no indication of malabsorption. Since the DGP is so specific, is it enough to go on to diagnose? Or is an endoscopy required as well?

I originally took her in because I suspected spots on her legs to be DH. They could not do a biopsy on the day we were there because of scheduling, so we set it up for today. Of course, the lesions healed beyond the point of getting a positive result (on adjacent skin), so I cancelled the biopsy. With no DH and no endoscopy, but a positive DGP, is the doc correct in NOT diagnosing her?
  • 0

Celiac.com Sponsor:

#2 mushroom

 
mushroom

    Mushroom

  • Advanced Members
  • PipPipPipPipPipPip
  • 9,448 posts
 

Posted 29 January 2013 - 05:10 PM

It is my personal opinion that he should do the endoscopy with a positive DGP, even with normal bloodwork and tTG. The DGP is very specific for celiac disease (i.e., nothing else that we know of elevates it, unlike the tTG). Dr. Rodney Ford (world eminent pediatric GI - here in Christchurch) believes that every child who has an elevated DGP will eventually develop celiac, whether or not they actually have it at the time of testing. I heard him speak on this subject about a family with one child with celiac and two with elevated DGP but negative biopsies. Within two years, both these other two children had celiac disease. So it is possible that the endoscopy would not turn up positive either, but I think it should enter into the picture. Many celiacs with negative tTG's have tested positive on biopsy.

So to answer your other question, if your doctor does not plan to follow up on this result, I would either wait until she has an active skin lesion and get it biopsied, or take her straight gluten free. I personally do not believe it is worth continuing to give her rat poison so the doctor can become convinced. He was supposed to pay for his own education :P Not all doctors are Dr. Rodney Ford :(
  • 0
Neroli


"Everything that can be counted does not necessarily count; everything that counts cannot necessarily be counted." - Albert Einstein

"Life is not weathering the storm; it is learning to dance in the rain"

"Whatever the question, the answer is always chocolate." Nigella Lawson

------------

Caffeine free 1973
Lactose free 1990
(Mis)diagnosed IBS, fibromyalgia '80's and '90's
Diagnosed psoriatic arthritis 2004
Self-diagnosed gluten intolerant, gluten-free Nov. 2007
Soy free March 2008
Nightshade free Feb 2009
Citric acid free June 2009
Potato starch free July 2009
(Totally) corn free Nov. 2009
Legume free March 2010
Now tolerant of lactose

Celiac.com - Celiac Disease Board Moderator

#3 GFinDC

 
GFinDC

    A little farting never hurt anybody... :-).

  • Advanced Members
  • PipPipPipPipPipPip
  • 4,160 posts
 

Posted 30 January 2013 - 08:46 AM

She may not have the worst symptoms of celiac disease yet, but that doesn't mean she wouldn't develop worsening symptoms over time if she continues to eat gluten. Her doctor isn't thinking quite right. He needs to consider the idea of preventative care once in awhile. Does he take his car to the shop when the check engine light comes on? Or wait until the engine falls out before talking to a mechanic? Grrr is a legal word here, so Grrr!
  • 0
Proverbs 25:16 "Hast thou found honey? eat so much as is sufficient for thee, lest thou be filled therewith, and vomit it."
Job 30:27 My bowels boiled, and rested not: the days of affliction prevented me.
Thyroid cyst and nodules, Lactose / casein intolerant. Diet positive, gene test pos, symptoms confirmed by Dr-head. My current bad list is: gluten, dairy, sulfites, coffee (the devil's brew), tea, Bug's Bunnies carrots, garbanzo beans of pain, soy- no joy, terrible turnips, tomatoes, peppers, potatoes, and hard work. have a good day! :-) Paul

#4 nvsmom

 
nvsmom

    Moderator

  • Moderators
  • PipPipPipPipPipPip
  • 3,587 posts
 

Posted 30 January 2013 - 08:54 AM

I was diagnosed with just blood work so I'm biased on simply accepting a positive blood test as indicating celiac. Those DGP tests are fairly specific to celiac disease as far as I know.

If the doctor is implying that her disease hasn't progressed much yet, then great! Although I have no idea how he can tell that from the blood work.... either way, she should go gluten-free once her testing is complete. Good luck.
  • 0
Nicole Posted Image

"Acceptance is the key to happiness."

ITP - 1993
Celiac - June, 2012
Hypothyroid - August, 2012

CANADIAN

Celiac.com - Celiac Disease Board Moderator

#5 mushroom

 
mushroom

    Mushroom

  • Advanced Members
  • PipPipPipPipPipPip
  • 9,448 posts
 

Posted 30 January 2013 - 12:17 PM

I just excerpted this for another poster, so thought I would pop it in here, too. :)

http://drrodneyford....erent-test.html

The old gliadin test. In the 1990s, the gliadin antibody test was developed. Although most celiacs had a positive IgG-gliadin antibody test, high levels of this antibody were found in about 10% of the normal population. Consequently, gliadin testing was considered non-specific” from the point of view of diagnosing celiac disease. Mistakenly, this led to IgG-gliadin being maligned as a useless and non-specific test .

Gluten sensitivity. The reality, however, is that an elevated IgG-gliadin antibody specifically means that the person is immunologically reacting to gluten. International research, including my own, has demonstrated that high gliadin anybody levels are frequently associated with clinical disease without the gut damage of celiac disease. This is now known as non-celiac gluten sensitivity, or the gluten syndrome.

Because of the poor predictive value of IgG-gliadin antibodies to detect celiac disease, this old gliadin test has been widely abandoned in the medical community – to the extent that most laboratories do not offer to do this test. But this is about to change.

DGP. This new deamidated gliadin peptide (DGP) antibody is the next big step along the journey. It is more sensitive and specific than EMA or tTG for the diagnosis of celiac disease. Unfortunately, its name is now being confused with the early old gliadin test.
Nicknames

Shortening names is universal, we call these nicknames. Whenever I am in Australia, I introduce myself as Rodney, but my friends call me Rod .

The same name strategy is being used for the DGP test. Instead of its full name, it has been shortened to the gliadin test – the identical name for the old gliadin test. But they test for very different things:

The new DGP gliadin test accurately indicates the gut damage of celiac disease.
The old IgG-gliadin antibody test indicates immunological reaction to gluten, and can help diagnose the gluten syndrome.

This is how to interpret what these gliadin antibodies mean:

A positive old test (IgG-gliadin antibody) usually means gluten sensitivity.
A positive new test (DGP-IgG and DGP-IgA) means celiac disease.
A negative old test usually means that gluten is unlikely to be a problem.
A negative new test means that celiac disease is unlikely at the time of the test, but it does not rule out gluten sensitivity.
  • 0
Neroli


"Everything that can be counted does not necessarily count; everything that counts cannot necessarily be counted." - Albert Einstein

"Life is not weathering the storm; it is learning to dance in the rain"

"Whatever the question, the answer is always chocolate." Nigella Lawson

------------

Caffeine free 1973
Lactose free 1990
(Mis)diagnosed IBS, fibromyalgia '80's and '90's
Diagnosed psoriatic arthritis 2004
Self-diagnosed gluten intolerant, gluten-free Nov. 2007
Soy free March 2008
Nightshade free Feb 2009
Citric acid free June 2009
Potato starch free July 2009
(Totally) corn free Nov. 2009
Legume free March 2010
Now tolerant of lactose

Celiac.com - Celiac Disease Board Moderator




0 user(s) are reading this topic

0 members, 0 guests, 0 anonymous users

Celiac.com Sponsors: