All labs normal range except DGP lab

[eeanderson898]

My daughter had all labs drawn my GI doctor. All celiac labs came back normal except DGP lab came back very elevated. Result >100, normal range 0-19. I'm told this lab is the least sensitive. Next step is now endoscopy. How likely is it she has celiac disease with this one abnormal lab? 

[trents]

  On 4/8/2024 at 4:50 PM, eeanderson898 said:

My daughter had all labs drawn my GI doctor. All celiac labs came back normal except DGP lab came back very elevated. Result >100, normal range 0-19. I'm told this lab is the least sensitive. Next step is now endoscopy. How likely is it she has celiac disease with this one abnormal lab? 

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First, how old is your daughter?

Second, when the blood draw was done for testing, was she still eating plenty gluten?

Third, the issue isn't that the DGP test is less sensitive but that it is less specific for celiac disease. And was this the DGP-IGA test or the DGP-IGG test?

Fourth, what are her symptoms.

[eeanderson898]

She is 4 years old. I believe it was a DGP-IGA test result. She has been eating plenty of gluten. She has been having stool soiling for a long time which prompted us to see GI in the first place. X-rays have confirmed constipation so we are also started in miralax and exlax daily to help regulate her BMs. 

[trents]

Thanks for the additional info. In answer to your original question, yes, it is certainly possible that your daughter has celiac disease with only the one positive test. In fact, seldom do we see all the test lights lit up. The DGP-IGA and DGP-IGG tests can be especially helpful with young children since their immune systems are immature and they often don't respond to the tTG-IGA test the same as adults would. 

[Scott Adams]

This article might be helpful. It breaks down each type of test, and what a positive results means in terms of the probability that you might have celiac disease. One test that always needs to be done is the IgA Levels/Deficiency Test (often called "Total IGA") because some people are naturally IGA deficient, and if this is the case, then certain blood tests for celiac disease might be false-negative, and other types of tests need to be done to make an accurate diagnosis. The article includes the "Mayo Clinic Protocol," which is the best overall protocol for results to be ~98% accurate.