Son's Testing Results - confused

[Metoo]

My son had two High Anti-Gliadin IgA results in a row, 22 and 23 (out of a scale of 10) so they sent him for a biopsy this was about 2 years ago.  I remembered the doctor telling us the biopsy was negative.  Now however I received electronic access to his records and this is what is written on the biopsy report.  His gastroentronologist left within a month of us doing the testing too, so I don't know who I could call to ask about this.    It says Pre-op diagnosis and post-op diagnosis is the Same!  I am super confused now, maybe I misunderstood.  I did have his blood work redone last year and his Anti-Gliadin IgA was down to 5.  

Anyone have any experience reading these reports, maybe they usually just leave that post-op diagnosis as same.

CLINICAL HISTORY: None given
PRE-OP DIAGNOSIS: Positive celiac screening
POST-OP DIAGNOSIS: same
SURGICAL PROCEDURE: EGD
SPECIMEN 1: Duodenal bx
SPECIMEN 2: Duodenal bulb bx
GROSS DESCRIPTION
1. Received in formalin labeled "duodenal biopsy" are multiple fragments
of tan tissue, 0.8 x 0.3 x 0.2 cm in aggregate dimension. Entirely
submitted as A.

2. Received in formalin labeled "duodenal bulb biopsy" are multiple
fragments of tan tissue, 0.5 x 0.3 x 0.2 cm in aggregate dimension.
MICROSCOPIC DIAGNOSIS
1. DUODENAL BIOPSY:
A. BENIGN DUODENAL MUCOSA.
B. NO EVIDENCE OF ACTIVE INFLAMMATION, VILLOUS ATROPHY, GRANULOMAS OR
ATYPIA.

2. DUODENAL BULB BIOPSY:
A. BENIGN DUODENAL MUCOSA WITH CRUSHED LYMPHOID AGGREGATE.
B. NO EVIDENCE OF ACTIVE INFLAMMATION, VILLOUS ATROPHY, GRANULOMAS OR
ATYPIA.

CLINICAL HISTORY:
None given
Diagnosis PreOp / PostOp: Positive celiac screening; same
Tissue Specimens: 1. Duodenal bx; 2. Duodenal bulb bx

 

[frieze]

  On 12/22/2020 at 1:39 PM, Metoo said:

My son had two High Anti-Gliadin IgA results in a row, 22 and 23 (out of a scale of 10) so they sent him for a biopsy this was about 2 years ago.  I remembered the doctor telling us the biopsy was negative.  Now however I received electronic access to his records and this is what is written on the biopsy report.  His gastroentronologist left within a month of us doing the testing too, so I don't know who I could call to ask about this.    It says Pre-op diagnosis and post-op diagnosis is the Same!  I am super confused now, maybe I misunderstood.  I did have his blood work redone last year and his Anti-Gliadin IgA was down to 5.  

Anyone have any experience reading these reports, maybe they usually just leave that post-op diagnosis as same.

CLINICAL HISTORY: None given
PRE-OP DIAGNOSIS: Positive celiac screening
POST-OP DIAGNOSIS: same
SURGICAL PROCEDURE: EGD
SPECIMEN 1: Duodenal bx
SPECIMEN 2: Duodenal bulb bx
GROSS DESCRIPTION
1. Received in formalin labeled "duodenal biopsy" are multiple fragments
of tan tissue, 0.8 x 0.3 x 0.2 cm in aggregate dimension. Entirely
submitted as A.

2. Received in formalin labeled "duodenal bulb biopsy" are multiple
fragments of tan tissue, 0.5 x 0.3 x 0.2 cm in aggregate dimension.
MICROSCOPIC DIAGNOSIS
1. DUODENAL BIOPSY:
A. BENIGN DUODENAL MUCOSA.
B. NO EVIDENCE OF ACTIVE INFLAMMATION, VILLOUS ATROPHY, GRANULOMAS OR
ATYPIA.

2. DUODENAL BULB BIOPSY:
A. BENIGN DUODENAL MUCOSA WITH CRUSHED LYMPHOID AGGREGATE.
B. NO EVIDENCE OF ACTIVE INFLAMMATION, VILLOUS ATROPHY, GRANULOMAS OR
ATYPIA.

CLINICAL HISTORY:
None given
Diagnosis PreOp / PostOp: Positive celiac screening; same
Tissue Specimens: 1. Duodenal bx; 2. Duodenal bulb bx

 

Expand Quote  

No evidence of celiac on biopsy. But that does not change the PRE procedure dx.  Has he been gluten free?

[Metoo]

No he hasn't been gluten free because I thought that they said he didn't have celiac.  I am really not sure what to do.  

[frieze]

Then he probably does not have celiac, with that drop on his labs...check out other causes for those elevations.

[GFinDC]

Hi metoo,

The positive blood results were positive for some reason.  The immune system is not a constant, unchanging thing.  Antibody levels can increase and decrease for no apparent reason in some cases.  Flares of symptoms in lupus, RA, or other AI conditions are an example.  I suggest you keep track of his symptoms and recheck his antibodies in 6 months or so.  Sooner if he develops GI symptoms or growth/weight issues.  Irritability, insomnia, pale mottled skin, or problems digesting dairy are all symptoms that could indicate a renewed antibody response.

 

[Scott Adams]

To me it looks like he has gluten sensitivity/intolerance, rather than celiac disease. If so, a gluten-free diet would still be recommended to avoid symptoms and it possibly leading to full-blown celiac disease at some point down the road. Have you had genetic screening done for the celiac disease genetic markers? You may want to consider this before ruling out a gluten-free diet for him.