Other Known Causes Of High Dgp Igg Besides Celiac?

[powerofpositivethinking]

I've posted a few times in other threads about this, but thought I'd start a new topic that puts my question right out there    Am I correct in thinking that if it was non-celiac gluten intolerance or gluten sensitivity, a person would not have elevated antibodies?  Does anybody have any research or articles that discuss other known causes of high DGP igG besides celiac?  

 

I have had two celiac panels done in the last month that contained the following tests:

DGP igG and igA

ttg igA and ttg igG

EMA

*I am not igA deficieint

 

Both times my DGP igG has been flagged as high, and everything else has been negative.  my GI doctor said he would look into if there were other things that would cause an elevated DGP igG level, but at that point, he wasn't aware of any.

 

any help is much appreciated!

 

 

[kareng]

I know you really hope you don't have Celiac but these links seem to say that the DGP- IgA. is very reliable.

http://www.cureceliacdisease.org/archives/faq/what-is-the-percentage-of-false-positives-for-dgp-iga

"What is the percentage of false positives for DGP-IgA?

DGP-IgA is less specific than DGP-IgG and should not be relied upon as a follow-up test for those with celiac disease."

http://www.cureceliacdisease.org/archives/faq/in-follow-up-blood-testing-why-would-ttg-be-negative-and-dgp-be-positive

In follow-up blood testing, why would tTG be negative and DGP be positive?

If the slightly positive test is the DGP-IgA, you can disregard this value, as it can be misleading. If the DGP-IgG is positive it probably means you’re ingesting small amounts of gluten, possibly from cross-contamination, which are raising antibodies but not enough to trigger a tTG or a mucosal response. Basically, in either case you shouldn’t worry too much.

http://www.cureceliacdisease.org/archives/faq/how-much-exposure-to-gluten-does-it-take-for-dgp-to-become-elevated-and-how-long-before-it-will-return-to-normal

How much exposure to gluten does it take for DGP to become elevated and how long before it will return to normal?

There is no general rule that applies to all, but we learn from each patient. That said, typically DGP are more sensitive to gluten than tTG, so they become elevated before tTG and disappear sooner than tTG once on a gluten-free diet.

[mushroom]

You might find this PubMed abstract interesting:

 

http://www.ncbi.nlm.nih.gov/pubmed/20042872

[powerofpositivethinking]

thanks for the links    I had actually read through those articles and FAQs during my previous research and was hoping someone would have a clear cut link answer like chicago does for other causes of raised ttg iga antibodies except for DGP igG antibodies http://www.cureceliacdisease.org/archives/faq/after-going-gluten-free-can-a-positive-ttg-mean-anything-other-than-gluten-present-in-my-diet 

 

If I was NCGI or gluten sensitive, I should not have raised DGP igG antibodies...yes/no?

[GottaSki]

Correct....in my opinion.

There are a few things that can temporarily raise tTG, but I have yet to find things other than celiac disease that falsely raised DGP - and I have done extensive pubmed searches along with asking each member that comes here with this question to ask their doctor for a reason besides Celiac Disease.

To date no one's doc has had an answer to that question - yet many of those doctors (most) suggest the wait and see if the patient becomes possitive on another antibody test as time passes. Horrid plan - again in my opinion - all that waiting is damaging the small intestine further which leads to problems in many of the body's systems.

[frieze]

Correct....in my opinion.

There are a few things that can temporarily raise tTG, but I have yet to find things other than celiac disease that falsely raised DGP - and I have done extensive pubmed searches along with asking each member that comes here with this question to ask their doctor for a reason besides Celiac Disease.

To date no one's doc has had an answer to that question - yet many of those doctors (most) suggest the wait and see if the patient becomes possitive on another antibody test as time passes. Horrid plan - again in my opinion - all that waiting is damaging the small intestine further which leads to problems in many of the body's systems.

I would have to agree.  It would seem the more logical step would to be to eliminate the potential cause, gluten, and see if it fixed the problem.....you know, that phrase about "do no harm"?

[guest134]

I had a DGP IgG of 11.5 on a >10 scale with salmonella and retest a few months later returned to negative. Mind you my initial result was so close to the positive/negative line that it could have just been laboratory error as well but perhaps the infection raised it temporarily? My IgA form was negative and I am IgA sufficient. 

[powerofpositivethinking]

I had a DGP IgG of 11.5 on a >10 scale with salmonella and retest a few months later returned to negative. Mind you my initial result was so close to the positive/negative line that it could have just been laboratory error as well but perhaps the infection raised it temporarily? My IgA form was negative and I am IgA sufficient. 

 

 

 

thanks for the suggestion!  I checked the symptoms of salmonella, but it doesn't seem to match-up with me.  My DGP igG tests were both strongly positive.  Greater than 30 was strongly positive for my lab, and I had a 43 and it dropped slightly to a 41 on the second testing.  My main symptoms are continuous bloating and frequent C for the last two years.  I've also tested low for vitamin d, k and potassium.

 

Correct....in my opinion.

There are a few things that can temporarily raise tTG, but I have yet to find things other than celiac disease that falsely raised DGP - and I have done extensive pubmed searches along with asking each member that comes here with this question to ask their doctor for a reason besides Celiac Disease.

To date no one's doc has had an answer to that question - yet many of those doctors (most) suggest the wait and see if the patient becomes possitive on another antibody test as time passes. Horrid plan - again in my opinion - all that waiting is damaging the small intestine further which leads to problems in many of the body's systems.

 

Lisa, thanks for the info!  I don't know if I'll get a chance to talk to my doctor before my EGD this Wednesday, but if yes, I'll try to remember to ask if he's been able to find a reason yet besides celiac for the elevated DGP igG.  If not, I'll ask him again during my April follow-up.  

[guest134]

Yeah, that's the thing, it is usually pretty easy to differentiate since salmonella comes hard and suddenly where as Celiac crops up slowly. 

[powerofpositivethinking]

so before my EGD today, I asked my GI if he was able to find another cause of high DGP igG besides celiac, and he said he was unable to locate another reason for the elevated number.  It was great to hear him say that there is a lot of ongoing research with celiac and food intolerance in general.  He said that for a long time doctors have told patients that the symptoms were all in their heads, but now the medical world is trending towards that these symptoms are not in patients' heads but instead the problems lie in their GI tract.  we could have all told him that 

 

He also talked about gluten intolerance, but I did ask him that if I did have gluten intolerance vs celiac, that shouldn't be raising my DGP igG antibodies, and he said that was correct.

 

My initial results from my EGD were a diagnosis of GERD and a hiatal hernia.  He took 8 biopsies and said there was slight inflammation in one area, so I will know the biopsy results in a few weeks!

[powerofpositivethinking]

wanted to add this link from Chicago's Celiac Website regarding DGP-IgG

 

http://www.cureceliacdisease.org/archives/faq/are-raised-dgp-igg-levels-an-early-sign-of-celiac-disease

[Mum in Norway]

Interesting.

Im having a biopsi done in less than two weeks, after the test showd DGP IgG of 10 (normal <7, positive >10) and very strong symptomes of celiac with heavy reactions to gluten, but every other blood value normal.

I realy feel like this could go eather way, and I don't know if I should hope for a positive for celiac, as that would provide some (alot of) answers, or if Im better of knowing for 'sure' that I don't have celiac, just a slightly elevated antibody against gluten... I realy can't that to make sence, that i would have elevated DGP IgG but not celiac, with the reactions I am having to gluten?

Oh well. Right now the maine focus is the day I can stop eating gluten again, afetr having done the biopsi

[Mum in Norway]

This is quite facsinating, powerofpositivethinking, as I had the exact same result as you! Slight inflamation, but not enough to call it celiac (you said somwhere that was the result of your biopsy?)

That is so strange! How can it be that we both have positive antibodies and inflamaition in the intestine, but that is not enough to deside its celiac, when we both have strong symptoms?

In my case it has been talk of wheat allergy, but I don't think that really fits, and doc says that if not then I clarely have non celiac gluten intolerance. But why would bot antibodys be elevated and intestine inflamed if i 'just' have intolerance?

[powerofpositivethinking]

I've gone back and forth on this so many times, and all I can say is I understand your frustration 

 

I tell people I have celiac because I do whether diagnosed by biopsy or not 

 

I tested a strong positive three times on the DGP IGG, and I had a normal IGA serum level, but all other tests were negative.  It's supposed to be 99% accurate, but that still doesn't seem to be good enough for the doctors to diagnose on that alone   The research I've found always says that IGG is a good indicator for those with low IGA serum, but I've often asked what about those that have a normal IGA level    

 

ttg iga is still seen as the top test according to doctors.  I'm not sure what, if anything, was discussed in relationship to the DGP tests at the International Celiac Disease Symposium.  

 

Your post made me go look over my EGD report again, and I was diagnosed with a medium sized hiatal hernia, GERD and a small nodule in the pyloric antrum which technically is right before my small intestines, so technically I didn't even have any inflammation found in my intestine, but then again it only went into the duodenum and didn't explore the jejunum and ileum.

 

Eventually I would like to get the gene test, but that will be in the future.  I thought about going to an allergist, but decided I had had enough of doctors for the time being, so I've been gluten free for 7 months, and I feel so much better!

 

I also agree that a positive antibody test means celiac and not gluten intolerance, but in the end the treatment is the same.  I know you had said in Norway you get financial assistance, so I was hoping you would get a firm diagnosis    In the US, there really isn't much financial assistance, so I decided to forgo fighting to be a doctor diagnosed celiac and diagnosed myself because you know yourself best 

 

here's another thread I went back and forth with the idea again https://www.celiac.com/forums/topic/101686-chicago-celiac-center-response-regarding-dgp-and-ttg/

 

please know you are not alone, and let me know what happens with the allergist.

 

have a great weekend!

 

This is quite facsinating, powerofpositivethinking, as I had the exact same result as you! Slight inflamation, but not enough to call it celiac (you said somwhere that was the result of your biopsy?)

That is so strange! How can it be that we both have positive antibodies and inflamaition in the intestine, but that is not enough to deside its celiac, when we both have strong symptoms?

In my case it has been talk of wheat allergy, but I don't think that really fits, and doc says that if not then I clarely have non celiac gluten intolerance. But why would bot antibodys be elevated and intestine inflamed if i 'just' have intolerance?

[powerofpositivethinking]

every so often I like to do searches on DGP IgG because I still have an obsession with it   Here's a powerpoint from the 2013 ICDS by Dr. Umberto Volta, Coordinator of the Italian Celiac Association Board, discussing NCGS.  on the 5th slide it says, "Deamidated gliadin antibodies (DGP) IgG were consistently negative in NCGS patients except for one case at a very low titer positivity."

 

http://www.drschaer-institute.com/smartedit/documents/download/drschaer_umberto_volta_gluten_sensitivity_biomarkers_and_epidemiology_the_ongoing_field_experience_2013.pdf

 

Here is the link to the original study: http://www.ncbi.nlm.nih.gov/pubmed/22138844

 

I found the original study awhile ago, and when reading it before I saw the statement, "Only 1 of the 78 patients with GS was positive for IgG DGP-AGA (detected in 88.7% of patients with celiac disease)."  

 

Now I know that one positive test was a weak positive that helps to further validate DGP IgG is only positive in cases of celiac disease and not NCGS.  

 

To date, I have had three strong positive DGP IgG tests, two with double the amount of what is considered normal, with a negative ttg IgA despite a normal IgA level.  My last test showed I finally entered the weak positive range, and that's been with no cheating, only eating at two restaurants, one of which is a completely dedicated gluten free facility and being super careful with CC    I've realized oats are a problem for me right now as I believe I have had two negative experiences with them and a bad experience/glutening with the Rice Dream milk.

 

I've put in other threads how I still feel like I'm in the gray zone, so I finally spent the money and am awaiting my genetic testing results!

[jebby]

In the pediatric population, the DGP-IgA can become positive when there is early bowel damage from celiac disease, long before villous atrophy and a positive TTG IgA occur. I can't help but assume that the same may happen in adults.

[powerofpositivethinking]

this new abstract in PubMed discusses DGP IgG in regards to non-responsive celiac disease and their diagnostic value:

 

http://www.ncbi.nlm.nih.gov/pubmed/24392888

[Rashi]

Hi, 

 

My Dgp igg has also been slightly higher than the range everything else being negative. I also had the gene test and biopsy done.. All negative for celiac. Would anyone know if any other gastrointestinal issue would cause the dgp igg to be elevated? 

[cyclinglady]

4 hours ago, Rashi said:

Hi, 

 

My Dgp igg has also been slightly higher than the range everything else being negative. I also had the gene test and biopsy done.. All negative for celiac. Would anyone know if any other gastrointestinal issue would cause the dgp igg to be elevated? 

My DGP IgA has chronically been elevated despite healing from celiac disease (had repeat intestinal biopsies to confirm healing).  However, I was diagnosed with Chronic Autoimmine Gastritis (but that was confirmed based on a stomach biopsy when they were checking my villi).   We think this might be affecting my celiac antibodies  test results though we can not find anything published to verify this.    Do you have any other autoimmune issues, like thyroiditis?  Has Crohn’s been ruled out?  My niece was diagnosed with Crohn’s after 4 Different GI visits.  The last GI ordered a pill camera and found the damage beyond the reach of both scopes.  Not saying you have Crohn’s, but  I am saying to be persistent and keep advocating for an answer.