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Genetic Testing


debmom

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debmom Newbie

My daughter, 16, who had terrible lower pelvic pain for 7 months and was diagnosed with thyroiditis, Reynauds and mold allergies within two months of each other, saw most of her symptoms resolve and the pain slowly disappear after we started a gluten free diet. In the midst of all her pain and 7 hospital visits, she had a colonoscopy (looking for Crohn's disease which she had shown "incipient" signs of on biopsies several years before) Her gastroenterologist said that this time there was no sign of Crohns, but she had a terrible case of gastritis in her stomach and intestines as she had on the first colonoscopy. She also has acid reflux but is allergic to all the medicines she has been given. A few months later we started the gluten free diet after reading of another child with similar symptoms who discovered she had celiac disease. Almost immediately she started getting better, but the pain didn't entirely resolve for another 6 weeks. She has had digestive problems since she was an infant and my sister and I have ulcerative colitis (no symptoms now for either of us after going gluten free with my daughter--)

We have just had the genetic testing done for DQ2 and DQ8 with test results that came back negative. We cannot get in to see the gastroenterologist until April, and he already thinks that she does not have celiac or gluten intolerance since he saw no blunting. What does it mean to have a negative test for the genes? Could she still have gluten intolerance that caused her severe pain?


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slee Apprentice

I do think she could have another type of gluten intollerence other than celiac, and it is not impossible that she could have celiac itself, but unlikely... we have just finished testing here for our family, including genetic testing. Some of us had the genes, some did not. The doctor that developed the genetic tests is a GI doctor at our hospital, so I think the doctors here are more familiar with what it all means. We were told that it is "unlikely" that one would have celiac without the major celiac genes... however, unlikely doesn't sound like impossible to me! One of my sons had negative genes but they did a bioposy anyways because of all of his symptoms. It came back unconclusive, but they still haven't ruled it out because of some things that could have indicated villi healing in his bioposy... anyways, to make a long story short, celiac is not impossible, but unlikely, another type of gluten intollerence is a definate possibilitiy...

shayesmom Rookie
We have just had the genetic testing done for DQ2 and DQ8 with test results that came back negative. We cannot get in to see the gastroenterologist until April, and he already thinks that she does not have celiac or gluten intolerance since he saw no blunting. What does it mean to have a negative test for the genes? Could she still have gluten intolerance that caused her severe pain?

DQ2 and DQ8 are the two genes that are recognized in the U.S. for celiac disease. Other countries recognize several other genes. This may explain why celiac disease takes an average of 11 years to diagnose in this country.

Here's a quick reference list of other celiac disease and gluten-sensitive genes.

Genes Associated with Celiac Disease vs. gluten sensitivity:

Celiac Disease

HLA-B8 Celiac disease

HLA-DQ2 Celiac disease

HLA-DQ7 Celiac disease

HLA-DQ8 Celiac disease

HLA-DQ9 Celiac disease

HLA-DR3 Celiac disease

Gluten sensitivity

HLA-DQ1 Gluten sensitivity

HLA-DQ3 Gluten sensitivity

HLA-DQ5 Gluten sensitivity

HLA-DQ6 Gluten sensitivity

gfpaperdoll Rookie

yes, & if you have a double copy of any of those gluten intolerance genes it is worse than if you have a DQ8 or a DQ2.

Just ask those of us that are double DQ1...

& if you are double DQ2 you are at a greater risk for T-cell Lymphoma. Here is a quote from an article on this site.

"HLA-DQ2 homozygosity means that a person has inherited the HLA-DQ2 gene from both parents.

In addition to having a much higher risk of developing celiac disease in general, people with HLA-DQ2 homozygosity have a much higher risk of developing refractory celiac disease type II, and enteropathy-associated T-cell lymphoma. Refractory celiac disease is a rare type of celiac disease in which a gluten-free diet fails to eliminate symptoms and to reverse celiac-associated damage. Eneteropathy-associated T-cell lymphoma is a type of cancer that often develops in people with advanced intestinal damage such as commonly found in celiac patients."

Of course no one is studying the problems that come with double gluten intolerant genes. But there are complications. That is why I always say to test thru Enterolab because they test for ALL the genes not just DQ2 or DQ8.

JustMe75 Enthusiast

Finally I found a post with info on DQ2 homozygosity! I didn't know all those things were associated with it! Scary!

I had myself along with my 2 daughters tested. One is DQ2 / DQ5 and myself and the youngest are DQ2 homozygous. I would love to know if she got one from me and one from her dad but we are divorced and dont speak much. The doctor said it is possible that she inherited both from me. In some types of homozygous genes a child can get both from one parent. Strange.

None of us has a celiac diagnosis, all 3 of our blood tests were negative, but I have improved probably 80-90% on the diet. So I guess I am lucky. Maybe I caught it before irreversible damage was done.

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    • trents
      Certainly, it would b wise to have a gene test done if your physician is open to it as it would provide some more data to understand what's going on. But keep in mind that the genetic test for celiac disease cannot be used as to diagnose celiac disease, only to establish the potential to develop active celiac disease. About 40% of the general population possess one or both of the primary genes known to be associated with the development of active celiac disease but only about 1% of the population actually develop active celiac disease. So, the gene test is an effective "rule out" tool but not an effective diagnostic tool.
    • Roses8721
      Had Quaker gluten-free oatmeal last night and my stomach is a mess today. NO flu but def stomach stuff. Anyone else?
    • Roses8721
      So you would be good with the diagnosis and not worry to check genetics etc etc? Appreciate your words!
    • Scott Adams
      As recommended by @Flash1970, you may want to get this: https://www.amazon.com/Curist-Lidocaine-Maximum-Strength-Topical/dp/B09DN7GR14/
    • Scott Adams
      For those who will likely remain gluten-free for life anyway due to well-known symptoms they have when eating gluten, my general advice is to ignore any doctors who push to go through a gluten challenge to get a formal diagnosis--and this is especially true for those who have severe symptoms when they eat gluten. It can take months, or even years to recover from such a challenge, so why do this if you already know that gluten is the culprit and you won't be eating it anyway?  Approximately 10x more people have non-celiac gluten sensitivity than have celiac disease, but there isn’t yet a test for NCGS. If your symptoms go away on a gluten-free diet it would likely signal NCGS--but those in this group will usually have negative tests, or at best, elevated antibodies that don't reach the level of official positive. Unfortunately test results for celiac disease are not always definitive, and many errors can be made when doing an endoscopy for celiac disease, and they can happen in many ways, for example not collecting the samples in the right areas, not collecting enough samples, or not interpreting the results properly and giving a Marsh score.  Many biopsy results can also be borderline, where there may be certain damage that could be associated with celiac disease, but it just doesn't quite reach the level necessary to make a formal diagnosis. The same is true for blood test results. Over the last 10 years or so a new "Weak Positive" range has been created by many labs for antibody results, which can simply lead to confusion (some doctors apparently believe that this means the patient can decide if they want more testing or to go gluten-free). There is no "Weak Negative" category, for example. Many patients are not told to eat gluten daily, lots of it, for the 6-8 week period leading up to their blood test, nor asked whether or not they've been eating gluten. Some patients even report to their doctors that they've been gluten-free for weeks or months before their blood tests, yet their doctors incorrectly say nothing to them about how this can affect their test, and create false negative results. Many people are not routinely given a total IGA blood test when doing a blood screening, which can lead to false negative interpretations if the patient has low IGA. We've seen on this forum many times that some doctors who are not fully up on how interpret the blood test results can tell patients that the don't need to follow a gluten-free diet or get more testing because only 1 of the 2 or 3 tests done in their panel is positive (wrong!), and the other 1 or 2 tests are negative.  Dermatologists often don't know how to do a proper skin biopsy for dermatitis herpetiformis, and when they do it wrongly their patient will continue to suffer with terrible DH itching, and all the risks associated with celiac disease. For many, the DH rash is the only presentation of celiac disease. These patients may end up on strong prescriptions for life to control their itching which also may have many negative side effects, for example Dapsone. Unfortunately many people will continue to suffer needlessly and eat gluten due to these errors in performing or interpreting celiac disease tests, but luckily some will find out about non-celiac gluten sensitivity on their own and go gluten-free and recover from their symptoms. Consider yourself lucky if you've figured out that gluten is the source of your health issues, and you've gone gluten-free, because many people will never figure this out.    
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