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Fecal Occult Moderate In Paediatric Patient


valerieanne

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valerieanne Newbie

I recently posted in the DH thread... My dd10 was diagnosed with DH almost five years ago, and we've been gluten-free since (I have celiac disease). Her annual cbc results are always borderline anemic/low iron, explained as 'her normal'. A new doctor this year ordered the fecal occult, which showed moderate levels of microscopic rbcs. She suspected a dairy protein allergy, and prescribed a dairy-free diet for three weeks, to be followed by repeat and additional tests.

We are one week into the GFDF diet, and ended up in emerg today. Dd had a head-toe rash. It was not DHish, but appeared to be an allergic rxn to something that was added/increased in her diet over the last week. Sigh. We are going back to our regular gluten-free diet, and I've requested a referral to an allergist.

My question is: Can trace amounts of gluten cause moderate levels of microscopic rbcs to show up in a fecal? I can't find this anywhere, but it seems it would be the obvious explanation. I've moved all of my husband's gluten foods into his office, reexamined every food item in the house, cleaned and sanitized...I think it is very possible that cross-contamination was happening. AND I found one food item (tortilla chips) that did not have gluten in their ingredients or allergen alert, but could be cross-contaminated at the factory.

TIA


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    • trents
      So the tTG-IGA at 28 is positive for celiac disease. There are some other medical conditions that can cause elevated tTG-IGA but this is unlikely. There are some people for whom the dairy protein casein can cause this but by far the most likely cause is celiac disease. Especially when your small bowel lining is "scalloped". Your Serum IGA 01 (aka, "total IGA") at 245 mg/dl is within normal range, indicating you are not IGA deficient. But I also think it would be wise to take your doctor's advice about the sucraid diet and avoiding dairy . . . at least until you experience healing and your gut has had a chance to heal, which can take around two years. After that, you can experiment with adding dairy back in and monitor symptoms. By the way, if you want the protein afforded by dairy but need to avoid casein, you can do so with whey protein powder. Whey is the other major protein in dairy.
    • jenniber
      hi, i want to say thank you to you and @trents   . after 2 phone calls to my GI, her office called me back to tell me that a blood test was “unnecessary” and that we should “follow the gold standard” and since my biopsy did not indicate celiac, to follow the no dairy and sucraid diet. i luckily have expendable income and made an appt for the labcorp blood test that day. i just got my results back and it indicates celiac disease i think 😭   im honestly happy bc now i KNOW and i can go gluten free. and i am SO MAD at this doctor for dismissing me for a simple blood test that wouldn’t have cost her anything !!!!!!!!!!! im sorry, im so emotional right now, i have been sick my whole life and never knew why, i feel so much better already   my results from labcorp:   Celiac Ab tTG TIgA w/Rflx Test Current Result and Flag Previous Result and Date Units Reference Interval t-Transglutaminase (tTG) IgA 01 28 High U/mL 0-3 Negative 0 - 3 Weak Positive 4 - 10 Positive >10 Tissue Transglutaminase (tTG) has been identified as the endomysial antigen. Studies have demonstrated that endomysial IgA antibodies have over 99% specificity for gluten sensitive enteropathy. Immunoglobulin A, Qn, Serum 01 245 mg/dL 87-352
    • JoJo0611
      Thank you this really helped. 
    • Samanthaeileen1
      Okay that is really good to know. So with that being positive and the other being high it makes sense she diagnosed her even without the endoscopy. So glad we caught it early. She had so many symptoms though that to me it was clear something was wrong.   yeah I think we had better test us and the other kids as well. 
    • GlorietaKaro
      One doctor suggested it, but then seemed irritated when I asked follow-up questions. Oh well—
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