Blood Test Just Above Normal Cut Off - Follow Up Or Fine?

[tri-gal]

My spouse has just had a blood panel done due to relatively mild but potential symptoms.

His DGP IgA came back at 10.1 with normal for lab at < 10.

All others were normal (DGP IgG and TTG IGA).

Doc interprets this as normal, no need to worry.

Views on whether my husband should pursue endo or just take it as  normal.?

thanks!

[Fenrir]

You should have a biopsy done. There is no such thing as a weak positive, if your result says positive at all you have a strong chance (95%+) of having celiac disease.

 

Also, was he still eating gluten when tested?

[tri-gal]

Thanks for your response. This was my sense too, yet his doc was not concerned and only  provided results when my husband asked for a copy.

My husband ate some gluten for around 8 weeks prior to the test,  not in great quantities, but probably equivalent to a couple slices of bread a day. He had been gluten light for about 10 months prior and had experienced improvements in stool issues as well as irritability.

[Fenrir]

Thanks for your response. This was my sense too, yet his doc was not concerned and only  provided results when my husband asked for a copy.

My husband ate some gluten for around 8 weeks prior to the test,  not in great quantities, but probably equivalent to a couple slices of bread a day. He had been gluten light for about 10 months prior and had experienced improvements in stool issues as well as irritability.

Given that he was cutting back on gluten for a long time before the test then only eating lightly glutened  for only 8 weeks I would certainly push for the EGD given the positive test. He will need to continue eating gluten until he has the EGD.

 

My tTG test was very weak positive, but my my EGD was 2nd highest grade (bad) as you can get.

[across]

My circumstances are almost exactly those of your husband. Weak positive DGB IgA, everything else normal. I had been gluten free for six months, with a three week lapse due to some plumbing issues making it difficult to cook. Doc said I didn't need to be eating gluten before the test. Doc said the results were not celiac, but gluten sensitivity, and planned no follow-up.

 

I did some research and decided I want a definitive diagnosis. I was going to be in the Chicago area, and called the Celiac Disease Center of the University of Chicago Medical Center to see about getting a biopsy while I was there. It didn't work out to do so because they aren't able to do phone consultations for follow-ups, and I live out of state, but they are going to recommend a doc in my state.  The nurse also said that elevated DGP IgA can be caused by other things, but did not specify what. She said that I should follow up with someone, and was going to talk to the doctor about who to follow up with. She had already told the doctor about my test results, and the doc had initially agreed to see me without a referral. Their willingness to see me tells me that my local internal medicine doc's plan to not follow up was not a good one.

[tri-gal]

Thank you for your responses. It has taken this long to finally get the doc to call back!

Indeed, he did ask his doc for a referral, right after we had  feedback on the forum, and it has taken this long for his doc to call him back (several attempts later...)

His doc does not want to refer for endo. Appointment tomorrow to discuss. Any suggestions? We are printing the lab info that says the sensitivity of their test is 65% whereas the specificity is 97%, therefore considered highly functional as diagnostic screening tool. Any ideas on how to handle this as we don't want conflict but we do want the assessment.

thanks again for taking the time.

[Cara in Boston]

What would lead your doctor to think he does not have celiac?  He had symptoms.  His symptoms improved when gluten was eliminated.  His blood test is positive.  What more does your doctor want?

 

The "lets wait until there is measurable damage even though you know you feel better gluten free" does not make any sense to me.

 

The test ranges are there for a reason.  They already account for individual differences (that is why there is a range).  If you are out of range, you are out of range.  The test is positive and indicates that there is a problem.

[tri-gal]

good news: he received the referral. Apparently the doc was concerned there wasn't sufficient justification to refer my husband.

when my husband pointed out the positive result he said ok, just that most people don't want an endo (weird). I suspect the doctor either did not review the results properly or understand the implication of them. At least the discussion led to a proper referral.

Also, my husband has a low platelet level which the doctor says is "normal" (?) ..."yes it is below normal but not worryingly so". hmmm.

[nvsmom]

good news: he received the referral. Apparently the doc was concerned there wasn't sufficient justification to refer my husband.

when my husband pointed out the positive result he said ok, just that most people don't want an endo (weird). I suspect the doctor either did not review the results properly or understand the implication of them. At least the discussion led to a proper referral.

Also, my husband has a low platelet level which the doctor says is "normal" (?) ..."yes it is below normal but not worryingly so". hmmm.

 

Low platelet count can be related to celiac disease. Usually it will improve with the gluten-free diet but occasionally it is a result of an autoimmune attack (ITP) and can be life threatening if platelet numbers dip too low. It's a good idea to keep an eye on that by getting it retested in a few months.  In the meantime, if he has increased bruising, fatigue, excessive nose or gum bleeding, or petechia (tiny red dots on skin) then he might want to get retested sooner.

 

Good luck with the endo.