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Hello!

My daughter was diagnosed with Celiac non-biopsied about 6 months ago.

When I recently went for my physical, I mentioned to my PCP that my daughter was Celiac, she said that I need to be tested. I took a blood test that day and here are the results:

Anti-Gliadin IgA                    

Gliadin Ab(s) IgA - 18.23U/ml    -      Standard Range: 0-15 U/ml   - Result: Positive

My PCP told me to start a gluten-free diet right away and she will re-test again in 6 months.

I was expecting a full panel, like my daughter had, not sure if it is necessary or not.

We elected not to put my daughter through a biopsy, as she was just recovering from a ruptured appendix and her GI Dr. agreed that he numbers were so high that she was fairly certain w/o biopsy that she was Celiac. My DD feels so much better.

Do you think this test is enough for me to start the gluten-free diet?

I actually have cut way back on gluten, as I somewhat eat what my daughter eats. So my test may have reflected that decrease.

Should I ask for more testing? Is this test sufficient?

Thanks for any assistance!!

 

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Why would your PCP go against the advice of leading celiac researchers and the American and British GI Associations?  The endoscopy/biopsy is still the gold standard for diagnosing celiac disease.     I understand your daughter's  situation, but I would get a second opinion from a GI before going gluten free.  

http://www.cureceliacdisease.org/screening/

http://gut.bmj.com/content/early/2014/06/10/gutjnl-2013-306578.long#T2

http://www.worldgastroenterology.org/guidelines/global-guidelines/celiac-disease/celiac-disease-english

 

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Personally, I would ask for the full Celiac panel and see what that shows.  I mean, the full Monty, not just cherry picking testing.  On the full panel, if the tTg and the EMA come back positive, that is a diagnosis without biopsy.  This is how I was diagnosed and there is absolutely no doubt I have Celiac.  I presented with classic celiac so it was a no brainer with my blood results.

If you cannot stick to the diet religiously, without cheating, unless you have a biopsy picture, then I would go on to have a biopsy.  Like your daughter, I was way too sick to have one done at the time.  They would not have agreed to use sedation because I was so anemic and malnourished and that ended that!  Good luck with whatever you decide!

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My daughter's PCP did not go against anything, she offered to do the biopsy - I was the one opposed to it. My DD, who was 10 at the time had just spent 3 weeks in the hospital, very sick with a ruptured appendix, then had 2 surgeries a few months after. I didn't see the need to put her through anything else with her numbers so high and all the classic symptoms.

Apparently, in some other countries, if your numbers are all high, they forego biopsy.

Anyway, I was really asking about myself and whether I should push for add'l testing. I am still new this this and trying to get up-to-date and wasn't sure if my PCP should conduct other blood tests before I go completely gluten-free. I have been somewhat gluten-free, but not entirely.

I have no problem going gluten-free, but want to make sure that I am doing it for the right reasons.

I wasn't sure if the Gliadin Abs IgA was sufficient to point to Celiac and possibly doing a biopsy for me. Or if additional blood test would make more sense.

 

Thanks!!

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Hi Lisa,

I completely understand why you didn't do a biopsy on your daughter.  I went through the appendix thing myself...not fun!  I was diagnosed with just bloodwork and no biopsy, but did have the full panel.  I would go back to your PCP and ask for a full panel to include TTG, EMA and DGP tests.  Since she was already willing to test you, I'm sure she would be willing to order these.  Good luck!

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I am glad that your daughter is improving and I completely understand why she did not get a biopsy.  Getting the full celiac panel (per Gemini's advice) is the best thing for you to do.  But I want to warn you.  I had the complete panel and I only had one positive (DGP IGA) like you.    I went on to get a biopsy because I needed to know for sure for two reasons.  The first was because my hubby had been gluten-free for 12 years and I knew the drill.  Being really gluten-free is hard and a huge commitment.  I could not believe that I needed to be gluten free too.  Second, I had anemia at the time.  No tummy issues.  I just went in for a routine colonoscopy because I am over 50.  My GI wanted to do an endoscopy too as he suspected celiac disease.  Biopsy revealed a Marsh Stage IIIB which translate to moderate to severe damage.  

I test the same in follow-up testing too.  Just the DGP IGA test is positive (got glutened last summer). 

So, a very positive diagnosis might not just help you, but others in your family besides you daughter.

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