Second opinion on lab results?

[Inkandpaper]

I just got lab results from my daughter’s labs, and the Pediatric gastroenterologist indicated that they show she does not have celiac.  Before I move on to look for other diagnoses, I would like a second opinion on the lab results.

Symptoms:

- Serious constipation

- Stomach pain 

- She isn’t growing much at all; in the last 2.5 years she’s gained about 2 lbs.  The only time her growth charts didn’t look alarming was when she was on the gaps diet (which is gluten free, among other things) for two years.  
 

Lab results:

- Iga, serum: 62 mg/dL (standard range 50-250 mg/dL)

- TTG Iga: <2.9 units (standard range <20 units)

Thank you!

[Inkandpaper]

Sorry, that should read <1.9 units for TTG Iga.

[trents]

Welcome to the forum.

 

How old is your daughter?

Has she had an upper GI with biopsy to check for the condition of the small bowel villi? The blood tests sometimes don't tell the whole story.

Has she had a colonoscopy? Could there be a partial blockage in there?

Gluten sensitivity instead of celiac disease?

Does she get enough fiber in her diet and drink plenty of fluids?

Low magnesium levels? 

Has she had a CBC and a CMP?

Edited August 17, 2020 by trents

[Inkandpaper]

Thanks for your response.  My daughter is 6.    She has not had a endoscopy or colonoscopy.  In addition to the labs I posted, she also had a basic metabolic panel, TSH, and Free T4 (all in normal range).

She gets plenty of fiber.  Her water intake isn’t great but not terrible either.  I have supplemented with magnesium with no results (even an adult dosage of magnesium sulfate daily still only had her pooping every 3-4 days).

[trents]

I would explore the option of an upper and lower GI with the doctors. I think docs are reluctant to do those on children but I'm sure it can be done. Maybe she has a kink in the bowel. Something is causing that abdominal pain. At her age I would not suspect Crohn's Disease. 

Okay, this is a little personal but how's the atmosphere in your home? Sometimes people, especially children, will manifest stress/anxiety in the gut. Anal retentive?

[cyclinglady]

I am sorry that your daughter is ill.  She did not get the complete celiac disease panel, which includes the DGP tests.  Those are better for younger children (and maybe even really old people, like me).  I test positive to only the DGP IgA and I am endoscopy/biopsy confirmed.  If my GI had not run the complete panel, my diagnosis would have been missed.  To further complicate the process, about 10% of celiacs are seronegative.  

https://www.aafp.org/afp/2017/0601/p726.html

Do you have autoimmune running in your family?  Just running a a few thyroid tests does not indicate autoimmune.  My kid has a normal thyroid panel (as did I) but both of us have very elevated thyroid antibodies.  My kid is 19.  
 

I would get a referral to a Ped GI.  At least push for the complete celiac disease panel from her PED or PCP.  

[DJFL77I]

do a CT scan of entire abdomen...  simple to do..

then get upper endoscopy...