Help Interpreting Test Results-quest Lab In Va

[Guest Waldenflo]

Im yet another new user, confused by Blood Test Results, which may be a diagnostic criteria for celiac disease, from what I'm reading! Brief background food allergy testing in '81 indicated Lactose Allergy/ Wheat "Intolerance". Was told by Allergist to go gluten free (gluten-free) for 6 mos, and could then reintroduce Gluten on a rotation diet, eating some gluten-not more often than every 4 days. I did that for maybe another 10 years. Eventually I found gluten-free = improved health!

In 2002, after being gluten-free for many years, I was anemic. Colonoscopy ruled out (r/o) intestinal bleed. The GI mentioned other possibilities, including celiac disease, which I'd long suspected. (The GI Dr. himself has celiac disease!) He advised a gluten challenge for 1 month before doing a blood celiac panel. So...pizza and beer...but only for 1 week. After a week, I told the Dr. I couldn't continue the challenge, due to huge increase in severe arthritis pain and the whole "gut-gamut"... brain fog, irritability, tummy-trouble... The Dr. ran the panel anyway, expecting it to be negative, which it was. However, he took a areful history and said " substantial anecdotal evidence suggests celiac disease". He didnt recommend biopsy as I'd been gluten-free for yrs.

This past April I had extensive back-surgery (Osteo-arthritis, Degenerative Discs) , and needed two units of transfused donor blood. I had a "subclinical" transfusion reaction (my Neurosurgeon and I eventually concluded) w/ temp of 102.5, which gradually dropped to 99.6-100.6 , despite 18 days of antibiotics. The temp. persisted for 11 weeks! My post-op weight went down 16 pounds; pre-op weight was 135... not a whole lotta lard on me to start with. After discharge, my Neuro ordered 3 separate post-op blood CBCs w/ differentials, Sed rates, complete metabolic panel, and LFTs with urine cultures, which were all negative for viral or bacterial infection. In looking at the blood test results, I noted a high avg. WBC count 9.8, (RR 3.9-10.0) and low-avg. RBC of 4.16 (RR 3.93-5.29). I also noted above-avg RDW of 15.3 ( RR 11.5-14.0) and asked my Dr. if I could be borderline anemic, which he ruled out. I found literature on Medline/Pub Med from Scandanavian Red Cross about transfusion reactions (TR) and celiac disease. I read that most TRs are sub-clinical...NOT severe, and symptoms sounded exactly like mine...pharyngitis, low grade temp., low energy... My FABULOUS Neurosurgeon and I now believe the temp. was most-likely am immune response to gluten proteins in the donor blood. PEOPLE WITH celiac disease OR GI...DON'T EVEN THINK OF HAVING ELECTIVE SURGERY WITHOUT FIRST BANKING YOUR OWN BLOOD, WHICH YOUR DR. CAN SET UP THROUGH RED CROSS SPECIAL COLLECTIONS. COLLECTION IS DONE FROM 40-10 DAYS BEFORE SURGERY! I've read a LOT lof celiac disease literature lately, and I can't believe how rarely this risk of a transfusion reaction is mentioned!

My Neuro recom. that my PCP follow me to monitor the low grade temp, post-op. Not knowing that the Celiac test would be negative, as I'd been gluten-free for years, I persuaded my PCP to test for Celiac. He agreed, thinking that if I were indeed having an immune response to Gluten proteins in the donor blood, the anitbodies might show up.

"Celiac Disease AB Panel" done 8 weeks post-op, by Quest Labs in Va; results are:

TEST RESULT REFERENCE RANGE

IgA 210 81-463 MG/dL

TISSUE TRANSGLUTANIMASE ab, IgA:

< 3 < 5 u/mL Negative

5-8 Equivocal

>8 Positive

GLIADIN AB IgA:

< 3 < 11 U/mL Negative

11-17 Equivocal

> 17 Positive

As I read these results, they are ALL NEGATIVE, which is what I NOW know to expect on a gluten-free diet, now that I've read more online. Am I correct??? I just want to make sure Im interpreting the test results correctly before I see my Dr. again for routine follow-up.

I understand that this does not rule out Celiac. Is there any need to ask for any further testing, to r/o or confirm a celiac disease diagnosis. I'm "high-maintainence" medically, which I never expected of myself...

w/ moderate Osteopenia, Mod-severe Osteoarthritis, Major Depression and ADHD (both well-controlled by meds...thank god!!!!!!!!!!!!) Only other known allergies are to insects, with 2 anaphalactic episodes after bites, but only after age 50!

Confirming or ruling out a celiac disease dx. could perhaps allow better long-term medical management of my other medical needs...as I already know how to manage my diet, whether this is celiac disease or not.

Great news...the back surgery outcome is SPECTACULAR, for which I adore my Neurosurgeon (let's give the MDs credit where it is due!!!) Im nearly pain-free in my spine, for the first time in 15 years!!! I feel as if I have "my life back" and want to make sure I do everything I can to remain well.

I am so impressed with the quality of information available here, and the MANY generous and good-hearted folks herein!

Thanks to all for the wealth of info and the vicarious support!