Update - High DGA IgG Bloodwork, Got Biopsy Results

[PrismagicMushroom]

Good news for the people who saw my last post. My biopsy went without a hitch and I've already got the results back a week later! 

Bad news....I have no idea what's going on anymore. I'm posting here just in case anyone else ever has a similar issue, so there's something that comes up in the site search.

As a refresh, here's the bloodwork from my rheumatologist that started everything (c/o Labcorp):

                   Name                            |     Result          |     Typical Range

Deamidated Gliadin Abs, IgA    |    4 units          |      0-19 units

Deamidated Gliadin Abs, IgG    | [H]  29 units  |      0-19 units

t-Transglutaminase (tTG) IgA    |    <2 U/mL       |      0-3 U/mL

t-Transglutaminase (tTG) IgG    |   <2 U/mL        |      0-5 U/mL  

Endomysial Antibody IgA         |   Negative        |      Negative

Immunoglobulin A, Qn, Serum |  278 mg/dL     |      87-352

 

My gastroenterologist decided that, with that result combined with my longstanding intestinal discomfort, it was worth doing the celiac biopsy even though he didn't seem convinced it would come back positive. He took 4 sample groups: two randomly placed duodenum, 1 lower stomach, and 1 esophageal. These results also came from Labcorp.

Samples 1 and 2 from the duodenum have the same results listed: "2-Duodenal mucosa shows preserved villous architecture and normal cellularity of the lamina propria. Brunner glands are identified. No gastric metaplasia is seen. No dysplasia or malignancy is identified. There are no viral inclusions. No Giardia, other parasites or other pathogenic organisms are seen. No Helicobacter pylori organisms are identified."

Sample 3 from the stomach lining: "3-Gastric mucosa shows moderately increased lymphoplasmacytic cells in the lamina propria. Focal neutrophilic activity is identified. No intestinal metaplasia is seen."

Sample 4 from the esophagus says: "4-Gastric-type mucosa shows a lymphoplasmacytic infiltrate in the lamina propria. Neutrophilic activity is not identified. No specialized epithelium of Barrett's is identified."

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Of course, when I google the things mentioned in samples 3 and 4, one of the things that comes up is that it's a symptom sometimes associated with celiac, though it's usually alongside villi damage, not instead of it. The most common cause appears to be long term NSAID use, but I have only been using NSAIDs daily for a few weeks, per my rheumatologist's preference to try non-steroidal approaches to inflammation as a first resort. I have been having most of my symptoms for years! And the other symptoms I have have been ramping up since January....nothing's changed in the last 6 weeks except that sometimes my joints hurt less thanks to the naproxen prescription.

My gastro follow up isn't until exactly a month from today, so I'm going to call and see if any cancellations open up. I'll post a final update once I see him and get his actual professional opinion.

[Scott Adams]

I don't recall all info from your last posts, but hopefully you were eating ~2 slices of bread's worth of gluten daily for 2 weeks before the endoscopy, and at least 6 weeks before the blood tests. 

You do have one positive blood test result, and you can find out more about what that means in the article below.

It could be that you have non-celiac gluten sensitivity, for which there currently isn't a test, yet ~10x more people have it, and a gluten-free diet is also the treatment. If your symptoms go away on a gluten-free diet then you likely have your answer. Also see the other article posted below, it's older, but very good.

 

 

[Victor2022]

What i am observing is this trend (with or without a symptom) that everything else is negative and "Deamidated Gliadin , IgG" is coming positive for many and most are relating this to celiac (even if tTG-IgA is within range & Total IGA is normal). Firstly why this test is prescribed, if it creates confusion, again i am seeing a trend that in many instance people go to lengths and find out no celiac/ non determined/nothing. Second: its sure that Antibodies are there so why they are there? what i think for gluten sensitivity/allergy there should not be a antibody. So for what these antibodies are generating or there is something else?

[Scott Adams]

From the article I posted:

Quote

The sensitivity of the DGP-IgG test is reported to range from 75% to 85%, which means it can correctly identify individuals with the condition in about 75% to 85% of cases. The specificity of the DGP-IgG test is reported to range from 75% to 95%, which means it can correctly identify individuals without the condition in about 75% to 95% of cases.