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Son's Testing Results - confused

Metoo
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Metoo Enthusiast
Metoo
Posted

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

 

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frieze Community Regular
frieze
Posted
5 hours ago, 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

 

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

Metoo Enthusiast
Metoo
Posted
  • Author

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 Community Regular
frieze
Posted

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

GFinDC Veteran
GFinDC
Posted

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 Grand Master
Scott Adams
Posted

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.

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