I Got Emily's Gi's Medical File.

[Jodele]

OK I had to go and get Emily’s medical records today. We are having problems getting blood test done for my other two kids. Our family Dr. can not find what lab to use because the labs they use do not have the celiac panel there. So I had to call the GI office and ask them what to do. They faxed there lab test to the family dr. Still waiting on that. Anyways, I went to the family dr. to get a different lab request for my middle child for testing her thyroid because she is a big girl and my dh has low thyroid. While I was there I ask for a copy of the blood work that the gi did on Emily and the nurse said that they did not have them and they had been trying to get them. I thought this was funny because our nurse showed me what they got form them and it was a statement from the gi dr. and did not memtion the last test that she ran on Emily. I ran down town to go to the children’ s hospital to get Emily’s record. This is what I got.

In 2000 blood test

Antigliadin IgA 9.0

AntiGliadin IgG 50.2

AntiEndomys IgA Negative

AntiTissTran IGA 2.3

Total Serum IgA 0.73

In 2006 blood test

Anti-Gliadin IgG 20.7

Anti-Gliadin IgA 0.4

TTG IgA 4.3

Anti-Endomysial Positive

IgA serological markers for celiac disease detected

] Celiac disease is highly likely

Then Emily biopsy states this

The clinical impression of celiac disease and the results of the serology evaluation are noted. Two of the biopsy pieces appear well oriented and demonstrate the expected villous-to-crypt ratio and normal villous histology. One portion of the specimen consists predominantly of superficial villous structures which do not show increased intraepithelial lymphocytes. CD3 evaluation of the density of intraepithelial lymphocytes is not further contributory.

Immunohistochemical study with appropriate positive and negative controls perform:

CD3: No significant increase in intraepithelial lymphocytes, 25 or less IEL/100 epithelial cells.

If anyone knows what the biopsy means please tell me I have no clue. They took 4 biopsy also. Thanks

Jodele

[2kids4me]

The clinical impression of celiac disease and the results of the serology evaluation are noted.

[ This means the pathologist actually read the lab results showing blood evidence of celiac disease]

Two of the biopsy pieces appear well oriented and demonstrate the expected villous-to-crypt ratio and normal villous histology.

[means they looked normal and the villi were not blunted - they were the right height and appearance at a cellular level]

One portion of the specimen consists predominantly of superficial villous structures which do not show increased intraepithelial lymphocytes.

[means they looked for evidence of lymphocytes in the villi - this would be an indication of immune mediated attack from a type of white blood cell responsible for immune mediated disease, superficial just means the surface of the intestinal wall where one would expect to see lymphocytes in an autoimmune process]

CD3 evaluation of the density of intraepithelial lymphocytes is not further contributory.

They did a special examination (stain or type of microscope) to make sure they didnt miss anything - the extra step did not "contribute" anything= no abnormalities

Immunohistochemical study with appropriate positive and negative controls perform:

CD3: No significant increase in intraepithelial lymphocytes, 25 or less IEL/100 epithelial cells.

[There is a special way they can stain/look at a slide that will highlight cells with high levels of immune markers - and nothing significant found]

In the end - the biospy was normal but the pathologist has noted that the lab results are consistent with celiac - so technically from a pathologists's point of view , he cannot say - no evidence of celiac because although the biopsy was negative, the lab work says celiac. Just not damage to villi yet.

Hope this helps. We have to read pathology reports daily at the vet clinic and it is easier if you know all the mumbo jumbo they have to write - just to say - we looked for everything but it was neg.

Go with the blood work, dont wait for the damage to show up, no need - the results speak for themselves

If anyone knows what the biopsy means please tell me I have no clue. They took 4 biopsy also. Thanks

Jodele

[Jodele]

Thank you very much!!!! I needed the plan english form of that. Now if it was about electronics or computers I could do that with no problem. Yes I was going to go off the blood work and she is gh now or trying the hardest right now. I am getting my other 2 kids and myself tested next week hopefully. Then the whole household with be gluten-free. Why I was asking is that we are having problems with the gi dr. here. My family dr. has been trying to get the results from the gi dr. and could not get what they wanted. So I went and got it today. You would not beleave what the gi dr. sent to my family dr. It was a statement about Emily and It was about the first time they tested her for celiac and not anything about the secont blood test they did. I don't like this dr but there is only 3 ped gi dr. here in okc and they all work out of the same office. I don't know if changing dr would help. If you were wondering why I waited until this year about this result because the gi dr never told me about the first blood test and Emily was just treated with reflux. The past year she had been getting worse with the stomic pains and ds. So we went back to the gi doc and thats when she said that she had a marker for celiac and now the dr said that she is not going to dx with celiac yet and wants to see her back in 6-8 months to see if there is any change with a gh diet. That was after I said I was going to put Emily on a gluten-free diet. I wish I know this 6 yrs. ago so that emily would not have to go though all the pain and would have been growing more. She is so small for her age. She wieghs 40lb and 46in tall. Thanks again for the enlightment of the pathology report.

Jodele

[2kids4me]

I would just ask your doctors office to request the most recent blood work. Be nice and say - oh its good to see the GI sent you the first report - can you ask for the more recent one as that has higher levels - thanks.

It may not be the GI , so much as the receptionist that sent the outdated report