Blood work/Endoscopy

[confusedbytest]

Hey all--have Hashimoto's and am being worked up for epigastric discomfort and IBS like symptoms---

 

My blood work had an IgA within the lower end of normal range, negative TTG, but weakly positive DGP.

 

My endoscopy showed a "nodular" duodenum with the biopsy stating there was "reactive lymphoid hyperplasia"...

 

I have a follow-up with the GI in 3 weeks.

 

Wondering about any help?

[confusedbytest]

I should say I am confused about how to interpret---

 

Does this mean celiac or no celiac?

 

Thank you all---I greatly appreciate it.

[ravenwoodglass]

While I am not a doctor it does sound like you are in the early stages of celiac. The DGP is quite specific to celiac and a positive is a positive. Keep eating gluten until after you see the GI then give the diet a good strict try for at least a couple months.

[ironictruth]

10 hours ago, confusedbytest said:

Hey all--have Hashimoto's and am being worked up for epigastric discomfort and IBS like symptoms---

 

My blood work had an IgA within the lowerend of normal range, negative TTG, but weakly positive DGP.

 

My endoscopy showed a "nodular" duodenum with the biopsy stating there was "reactive lymphoid hyperplasia"...

 

I have a follow-up with the GI in 3 weeks.

 

Wondering about any help?

Trust me, I have spoken to three US celiac research centers and one additional foreign expert and DGP is not that specific. Was it the IGA or IGG? Or does it not specify?

Here is one example:

Open Original Shared Link

That being said, it is still positive and can catch some folks with gluten problems (especially IGA deficient) so your bloodwork warrants getting the genetic test done. Was the EMA done? I was also recently informed by a researcher that the older gliadin (AGA) tests are useful in non celiac gluten sensitivity and  I think the research is still incredibly fuzzy about what happens if somebody with non celiac gluten sensitivity stays on gluten. I am going to try to get my AGA taken as well however the names that are used can be very similar and confusing to doctors when they order the labs and some Labs do not even use the AGA tests anymore. 

You will have to talk with your doctor about a diagnosis.  Do you know how many samples were taken for the biopsy in from where? And was             h-pylori rule that?

Best of luck and health. Keep us posted. 

 

[confusedbytest]

Thanks. 

 

I don't know how many biopsies and the only comment I have on my patient access portal is about the lymphoid hyperplasia and nothing about the crypts/villi being abnormal or normal.  

My H pylori was negative. 

 

 

 

 

 

 

 

 

[Jmg]

Welcome

11 hours ago, confusedbytest said:

My endoscopy showed a "nodular" duodenum with the biopsy stating there was "reactive lymphoid hyperplasia"..

Had a quick google out of interest Open Original Shared Link:

Quote

The link between NLH and celiac disease seems to be rare[Open Original Shared Link,Open Original Shared Link]. It is important to underline that CVID patients may present small-bowel pathology similar to classic celiac sprue, known as “pseudo-celiac” pattern, with short villi, crypt hyperplasia, intraepithelial lymphocytosis, and, in some cases, an increase in apoptotic bodies in crypt epithelial cells. The diagnosis of CVID should be suspected when the number of plasma cells are reduced or absent in the lamina propria, and patients do not produce antibodies to tissue transglutaminase, endomysium, or gliadin. CVID patients typically do not respond to gluten withdrawal and do not express the genes associated with celiac disease, HLA-DQ2 and HLA-DQ8[Open Original Shared Link,Open Original Shared Link].

 Hopefully your GI consult can shed some further light. 

One suggestion. If your GI excludes celiac and you choose not to pursue further testing, give the gluten free diet a try in any case. It's possible you test negative but are still affected and avoiding gluten may still be the right course for you.  

I know this investigation phase is stressful and hard work. Best of luck, hope you get the answers you need.  

 

[confusedbytest]

Thanks---

 

Not sure what to think.  Appreciate all of your help.