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lucybear

2 Year Old Diagnosed Anemic, Waiting On Celiac Testing

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So, we started him on an iron supplement to treat the anemia. His hemoglobin was at 10.2. We've been doing iron at night (6ml) liquid Iron-Fel-Sol drops for about 2 weeks now. We're waiting on his Celiac blood panel results to come back. At the time they drew that blood, they also looked at his hemoglobin again. It's up to 11.2. So, we're excited that it's responding to the iron supplement, but I'm confused. Does that mean that since he's absorbing the iron supplement that it's not Celiac? Or does Celiac just cause problems with absorbing nutrients from food?

An endoscopy when he was 10 months old showed IEL's, but not concentrated in the villous tips. But it also showed mild villous blunting. The pathology comments suggested findings might be indicative of early celiac sprue, but that findings would need to be corraborated with blood testing and clinical findings. Blood testing at that time was negative. Lots of clinical issues at this time though, mainly anemia, with extreme muscle weakness, low tone and fatigue. These issues are not responding to physical therapy. If it's not Celiac, it could be a much worse neurological problem. Obviously, we are hoping it is Celiac so that it is treatable. Does the improvement in hemoglobin after starting an iron supplement mean it's not Celiac?

Our appt. with our GI doc is not until Friday. Thanks!

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my heart goes out to you. My daughter had hypotonia, fatigue, and fell behind developmentally until she was classified as global developmental delay. The various tests they wanted to do seemed never ending but they did have to rule out a number of issues that can cause hypotonia and it would be negligent for them NOT to do investigations since early therapies can help.

Responding to iron does not rule out celiac or rule it in ...wait til you see the GI doc.

My daughter was not diganosed celiac til age 11..

She has a n mber of medical conditions that contributed to her fatigue. Her hypotonia is brain based and she had many interventions and therapies along the way. She did not walk until she was almost 4..

She was tentatively diagnosed with SMA until genetic testing proved that was not the case.

Anyways, the wait will seem like forever - glad his hemoglobin improved and give him a hug.

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The original biopsy at 10 months is a diagnosis of celiac. You do not need any other tests - villi blunting is celiac, total villi blunting is near death. The child needs to be gluten free...

Not necessarily, esp in a young child. Villi blunting alone is not definitively celiac. they look for various cell types in the the crypts to diagnose. I will find another post re: villi blunting and give the link to pathology of small intestine and what can resemble celiac.

EDIT/ add on

from: http://www.nature.com/modpathol/journal/v1...l/3880771a.html

On biopsy, however, some other conditions can mimic aspects of celiac disease. Some of these conditions and useful differential diagnostic points are summarized here:

- Autoimmune enteropathy: crypt injury/destruction; anti-enterocyte antibodies in 50% of cases. Onset usually in the first 6 months after birth.

-Tropical sprue: lack of antiendomysial antibodies; response to antibiotic and folate therapy.

-Common variable immunodeficiency: paucity or absence of plasma cells; marked lymphoid nodular hyperplasia; Giardia infection common.

-Infectious (usually viral) enteritis: normal IEL counts.

-Food protein intolerance (eggs, cow milk, etc.): increased eosinophils; other allergic manifestation (asthma, atopy); response to elimination diets.

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