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Dr diagnosed me based on this (blood results inside)


Haveaniceday

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Haveaniceday Apprentice

Hello.

I recently got very sick with lots of symptoms noted with celiacs. My Dr said I will need an endescopy to assess damage, but that the blood test I received were highly specific, and she went ahead and diagnosed. I'm just wondering if there is any way this is wrong?

My esr and immature granulocytes were both high too. But iron and b12 were fine.

 

Thanks!

20201015_025506.webp


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plumbago Experienced

The second of your tests, (TTG IgA) is not 100% specific: there are other causes of a positive test, including diabetes, heart failure, Crohn’s and others. (Also, people who have celiac disease can get a negative result with this test.) This test is machine-read. (Background: The enzyme TTG deamidates gliadin (a broken-down component of gluten). In reaction to the presence of TTG, the antibody immunoglobulin A (IgA) is produced. Raised IgA antibodies indicate short-term immune response, indicating ingestion of gluten 2-4 weeks preceding the test.)

The first test you present measures antibodies directed against deamidated Gliadin peptides (DGP) in human serum or plasma.

Immunoglobulin A lines mucus membranes and protects body surfaces. Found in highest quantities: eyes, mouth, nose, GI tract. Raised IgA antibodies indicate short-term immune response, indicating ingestion of gluten 2-4 weeks preceding the test.

So far, everything is strongly suggestive of celiac disease and as always I tell people to listen to their docs over us on the Internet. More tests than these are usually ordered to diagnose celiac disease - what you had is not the typical so-called Celiac Panel. But again, it's all strongly suggestive. You could always ask for another round of tests, more complete this time. That's what I did. My next round of tests still showed the same thing, so then I got the biopsies and was diagnosed based on those plus the previous blood tests. You will need to continue eating gluten-containing foods if you opt for more tests and you will need to continue eating gluten-containing foods for biopsies, as well.

Plumbago

Scott Adams Grand Master

I would not second guess your doctor as you have two strong positive tests that are very specific to celiac disease. I will assume that they have recommended that you go on a 100% gluten-free diet. This article may be helpful:

 

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    • trents
      Let me hasten to add that if you will be undergoing an endoscopy/biopsy, it is critical that you do not begin efforts to reduce gluten beforehand. Doing so will render the results invalid as it will allow the small bowel lining to heal and, therefore, obscure the damage done by celiac disease which is what the biopsy is looking for.
    • Scott Adams
      This article, and the comments below it, may be helpful:    
    • Scott Adams
      That’s a really tough situation. A few key points: as mentioned, a gluten challenge does require daily gluten for several weeks to make blood tests meaningful, but negative tests after limited exposure aren’t reliable. Dermatitis herpetiformis can also be tricky to diagnose unless the biopsy is taken from normal-looking skin next to a lesion. Some people with celiac or DH don’t react every time they’re exposed, so lack of symptoms doesn’t rule it out. Given your history and family cancer risk, this is something I’d strongly discuss with a celiac-experienced gastroenterologist or dermatologist before attempting a challenge on your own, so risks and benefits are clearly weighed.
    • Greymo
      https://celiac.org/glutenexposuremarkers/    yes, two hours after accidents ingesting gluten I am vomiting and then diarrhea- then exhaustion and a headache. see the article above- There is research that shows our reactions.
    • trents
      Concerning the EMA positive result, the EMA was the original blood test developed to detect celiac disease and has largely been replaced by the tTG-IGA which has a similar reliability confidence but is much less expensive to run. Yes, a positive EMA is very strong evidence of celiac disease but not foolproof. In the UK, a tTG-IGA score that is 10x normal or greater will often result in foregoing the endoscopy/biopsy. Weaker positives on the tTG-IGA still trigger the endoscopy/biopsy. That protocol is being considered in the US but is not yet in place.
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