Get email alerts Get Celiac.com E-mail Alerts  




Celiac.com Sponsor:
Celiac.com Sponsor:




Ads by Google:






   Get email alerts  Subscribe to FREE Celiac.com email alerts

Dgp Question....
0

5 posts in this topic

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

Share this post


Link to post
Share on other sites


Ads by Google:

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

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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

http://drrodneyford.com/extra/documents/279-gliadin-antibody-confusion-same-name-different-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

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!


Register a new account

Sign in

Already have an account? Sign in here.


Sign In Now
0

  • Forum Statistics

    • Total Topics
      103,873
    • Total Posts
      919,412
  • Topics

  • Posts

    • Toblerone
      I don't eat chocolate often, but I have never had a gluten reaction to Toblerone. I trust it to be gluten-free.
    • So I've been glutened....
      I am so sorry for how your feeling.  I can sympathize; over time I notice I couldn't have any type of gluten free products.  I read that since you don't have villi in your small intestines you have no defenses, meaning even the tiniest bit of exposure causes a flare up.  I even have to be careful when I purchase products by reading the labels to ensure it says manufactured by a nut, soy, milk and wheat free facility.  Be very careful, unfortunately
    • Symptoms despite strict gluten-free -- new here
      I have been reading a lot about leak gut syndrome which is new to the medical community in the sense that they don't know how to manage it.  If (you are female) make sure to do a yearly pap and uterine check to ensure there is no issues there.  If you are not a female then definitely confirm with an endoscopy if your small intestines are still damaged.  I am looking into doing the leaky gut diet to see if it will help, the book I am reading is "Eat Dirt" by Dr Josh Axe.  Especially since I notice anytime I am exposed to gluten by accident my symptoms are worse each and every time.  I know get severe back and rib cage pain, with bloating, gurgling and diarrhea with severe nausea.  I am willing to try anything and I am now reading this book and applying the diet to see if I can heal my intestinal lining.
    • Help
      Ok so I had my colonoscopy & endoscopy last Thursday. Don't get results until July 13th as GI is on vacation. I've had bad pain in my lower left abdomen that wraps around to my lower back as well for the past 4 days..even hurts to touch lightly. Went back to the ER & they did an ultrasound & CT scan. The Doctor said that I have "prominent" lymph nodes in the area that is painful as well as thickening & inflammation of my Sigmond colon? Um ok what is that all about? Kind of freaking out over the whole swollen lymph nodes thing. Has anyone ever dealt with this before? 😒
    • Enormous Stool
      My 2 year old daughter has sufferd with extremely large stools for over a year. She will have a bm once or twice a week there has been blood sometimes i took her to the docs and they gave her some stool softner which didnt help they tried uping the dose which still didnt help and they told me it would eventually work which didnt she was then put on movicol which she was only supposed to get half a sachet still no diffrence i uped it to the the full sachet which helps a little she doesnt always have large stools but most of the time she does. She has got to a stage where she clenches and wont let it out because of how sore it is i try to put her on the toilet for it to come a little easier for her but she screams and will try hide herself in a corner and wont let you anywere near her it is heart breaking to watch her. If anyone has any in advice i would really like to hear.   Thanks.
  • Upcoming Events

  • Blog Entries

  • Recent Status Updates

    • Jmg  »  admin

      Hello Admin!
      I don't know whether this is of interest to post on your articles feed:
      http://pratt.duke.edu/about/news/window-guts-brain
      Kind Regards,
      Matt
      · 2 replies
    • celiac sharon  »  cyclinglady

      Hello cycling lady, have you noticed my picture is showing up as you?  Have no idea why but it's rather disconcerting to see my picture and your words 😉  Do you know how to fix it?  You seem to have far more experience with this board than I do
      · 1 reply
    • Larry Gessner  »  cyclinglady

      Hi There, I don't know if there is a place for videos in the forum. I just watched "The Truth About Gluten" I think it is a good video. I would like to share it somewhere but don't know where it should go. Any help would be greatly appreciated.
      Here is the link if you have never watched it.
      https://youtu.be/IU6jVEwpjnE Thank You,
      Larry
      · 2 replies
  • Who's Online (See full list)

    There are no registered users currently online

  • Member Statistics

    • Total Members
      60,909
    • Most Online
      1,763

    Newest Member
    Fourpeople
    Joined