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Help With Pathology Reports?


millersinkenya

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millersinkenya Rookie

Hi! I am new here and I am just looking for some opinions. My son has had some major health issues for the last couple of years (he is now 3.5 years old). With out going into a lot of detail, I was wondering if anyone could look at his pathology reports from almost two years ago. We were told he did not have celiac but I am thinking that the GI doctor who told us that may be wrong. He is still having a lot of issues now and has started to get migraines for the last year. They have ruled anything out contributing to migraines and medicine is not working. He is having about 2 per week at this point. I read that celiac can contribute to migraines, so here I am! I asked the GI doctor to forward me his reports (his biopsies were read by two different pathologists) and I was shocked when on both of them, the path suggests celiac. I think he had blood work done but it was negative. He was 1y11m at the time of all of this. Does anyone know how to read pathology reports? I am including the final pages from both pathologists.

The kicker to all of this is that we live in Africa and there are no doctors here who know what celiac disease is to go and talk to about everything. I am starting him on a gluten-free diet now in hopes of helping, but I am just not really sure what the reports mean!

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Twinklestars Contributor

I am relatively new to all this, but the report clearly states there is some blunting of villi and also says his results are suggestive of celiac disease. I would think it would make sense given his age, that his villi are not going to be dramatically damaged at this stage. But the fact there is some damage there suggests a positive celiac diagnosis and he should most definitely be on a gluten free diet.

Please someone with more experience correct me if I'm wrong?

ravenwoodglass Mentor

Welcome to the forum. His pathology reports are consistent with celiac disease. False negatives on both blood and biopsy are not uncommon but false positives are not. When the one or the other is positive a person does have celiac. All his first degree relatives, Mom, Dad and siblings should now also be screened even if they don't seem to have the same or any symptoms. You are in a good place to learn how to do the gluten free lifestyle so ask any questions you need to and read as much as you can here.

kareng Grand Master

Send a brief note like what you wrote above and the attachments. The email address is on the website:

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Maybe hearing it from a doctor who knows about Celiac will help your doctors.

Roda Rising Star

I'm sorry that you have been going through a hard time with your little one. As Raven said his pathology reports are consistent with early changes associated with celiac. In the absence of other illness, then your doctor should have given the diagnosis of celiac and saved your poor child a few years of misery. You did the right thing by requesting his reoprts. Since you have had this happen I would, everytime he has any blood work or procedures, get written copies of everything. Now is as good a time as any to start him gluten free. All first degree relatives should be screened also ie, mom, dad, siblings.

millersinkenya Rookie

That is what I was thinking. The thing that kind of makes me a bit mad is the fact that this is from a year and a half ago. He may have only had minimal blunting then, but what damage have a done to him since then because of doctor error (if there is error)? I am just so frustrated about this. And, we have just moved to Africa for my husband's work- had we known this, we may not have moved because there are no doctors here at all that know what celiac is or how to deal with it clinically, along with the other associated issues with celiac.

Any other opinions? Thank you so much for your input, this forum has been a great resource for me from here!

millersinkenya Rookie

Thank you so much, everyone. I was afraid that this what you guys would say as well. I am just so completely unsure of why the ball got dropped by the doctors. I will send an email to the UofC address to see what they can say. I just don't know what to do from here as far as health care is concerned. We can do a gluten free diet, but here the labels are not very accurate on foods, etc., and it is just going to be hard (and very expensive). I called the hospitals here and no one could connect me with a doctor. Wish I could have a doctor trained here on celiac!

Thanks again :)


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ravenwoodglass Mentor

Thank you so much, everyone. I was afraid that this what you guys would say as well. I am just so completely unsure of why the ball got dropped by the doctors. I will send an email to the UofC address to see what they can say. I just don't know what to do from here as far as health care is concerned. We can do a gluten free diet, but here the labels are not very accurate on foods, etc., and it is just going to be hard (and very expensive). I called the hospitals here and no one could connect me with a doctor. Wish I could have a doctor trained here on celiac!

Thanks again :)

Go with as much whole unprocessed food as you can. That is cheaper and safer than looking for gluten free specialty foods. Meats, chicken, veggies, fruits, beans, rice etc are all gluten free in their natural form. Since the gluten free diet is the only treatment for celiac at least you didn't discover he needed something that required meds that you might not be able to access.

JoshB Apprentice

That's certainly suggestive of celiac disease. Unfortunately with only level 1 marsh changes it's not even close to diagnostic, and I think your location may raise the likely-hood of other the other potential problems. At the age of one I don't think that a blood test would be likely to be effective; his immune system wouldn't have developed to the point where he would start showing normal signs. However, at the age of four it's much more likely that he would test normally.

In light of that I would suggest:

#1 -- Redo the blood test, before starting a gluten free diet. If at all possible make sure they use "deamidated gliadin peptide", which is supposedly more effective with young children.

#2 -- If the test is positive, be glad you know what it is and start the gluten free diet.

#3 -- If the test is negative, start gluten free anyway -- he may still be too young for the blood test. Now you'll have to evaluate effectiveness for yourself.

millersinkenya Rookie

That's certainly suggestive of celiac disease. Unfortunately with only level 1 marsh changes it's not even close to diagnostic, and I think your location may raise the likely-hood of other the other potential problems. At the age of one I don't think that a blood test would be likely to be effective; his immune system wouldn't have developed to the point where he would start showing normal signs. However, at the age of four it's much more likely that he would test normally.

In light of that I would suggest:

#1 -- Redo the blood test, before starting a gluten free diet. If at all possible make sure they use "deamidated gliadin peptide", which is supposedly more effective with young children.

#2 -- If the test is positive, be glad you know what it is and start the gluten free diet.

#3 -- If the test is negative, start gluten free anyway -- he may still be too young for the blood test. Now you'll have to evaluate effectiveness for yourself.

Thanks! we just moved here 2 months ago, so being in Africa would have no effect on the past test results. We lived in Colorado at the time. What do you mean that it is not even close to diagnostic? I am new to this, so I do not know, but wouldn't any villi blunting be indicative of gluten issues? The main issue with being here is that the doctors do not know what it is or how to test for it. The only lab that knew what I was talking about said that they would have to see about the tests and would have to send them overseas. Not sure we can afford that right now! What would be considered diagnostic as far as the biposies are concerned? Can a path tell a difference between gluten sensitivity and celiac?

Roda Rising Star

I have to disagree with Josh B (sorry Josh, not picking on you at all). He is right in the fact that the blood work is more unreliable in children giving more false negatives. I'm not sure how much more suggestive your report needs to be except with total villi blunting. And I aggree with you if indeed it is celiac from 1.5 years ago, the damage may very well have progressed. If it was me I wouldn't hesitate to go gluten free based on the previous path report. He does raise a good point, if you can, get him bood tested again before he goes gluten free.

millersinkenya Rookie

Thanks all!

millersinkenya Rookie

UPDATE:

The GI doctor has written back to me and stated that it does show that he should be diagnosed with Celiac Disease. They are sending me information on Monday. I guess we are officially gluten-free around here.

Roda Rising Star

UPDATE:

The GI doctor has written back to me and stated that it does show that he should be diagnosed with Celiac Disease. They are sending me information on Monday. I guess we are officially gluten-free around here.

Glad you got such a quick response.

ravenwoodglass Mentor

UPDATE:

The GI doctor has written back to me and stated that it does show that he should be diagnosed with Celiac Disease. They are sending me information on Monday. I guess we are officially gluten-free around here.

That's great news. Glad it got straighted out and hope things are going well soon.

Twinklestars Contributor

That's great they got back to you so quickly! Welcome to the world of gluten free :)

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    • marion wheaton
      Thanks for responding. I researched further and Lindt Lindor chocolate balls do contain barely malt powder which contains gluten. I was surprised at all of the conflicting information I found when I checked online.
    • trents
      @BlessedinBoston, it is possible that in Canada the product in question is formulated differently than in the USA or at least processed in in a facility that precludes cross contamination. I assume from your user name that you are in the USA. And it is also possible that the product meets the FDA requirement of not more than 20ppm of gluten but you are a super sensitive celiac for whom that standard is insufficient. 
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      No,Lindt is not gluten free no matter what they say on their website. I found out the hard way when I was newly diagnosed in 2000. At that time the Lindt truffles were just becoming popular and were only sold in small specialty shops at the mall. You couldn't buy them in any stores like today and I was obsessed with them 😁. Took me a while to get around to checking them and was heartbroken when I saw they were absolutely not gluten free 😔. Felt the same when I realized Twizzlers weren't either. Took me a while to get my diet on order after being diagnosed. I was diagnosed with small bowel non Hodgkins lymphoma at the same time. So it was a very stressful time to say the least. Hope this helps 😁.
    • knitty kitty
      @Jmartes71, I understand your frustration and anger.  I've been in a similar situation where no doctor took me seriously, accused me of making things up, and eventually sent me home to suffer alone.   My doctors did not recognize nutritional deficiencies.  Doctors are trained in medical learning institutions that are funded by pharmaceutical companies.  They are taught which medications cover up which symptoms.  Doctors are required to take twenty  hours of nutritional education in seven years of medical training.  (They can earn nine hours in Nutrition by taking a three day weekend seminar.)  They are taught nutritional deficiencies are passe' and don't happen in our well fed Western society any more.  In Celiac Disease, the autoimmune response and inflammation affects the absorption of ALL the essential vitamins and minerals.  Correcting nutritional deficiencies caused by malabsorption is essential!  I begged my doctor to check my Vitamin D level, which he did only after making sure my insurance would cover it.  When my Vitamin D came back extremely low, my doctor was very surprised, but refused to test for further nutritional deficiencies because he "couldn't make money prescribing vitamins.". I believe it was beyond his knowledge, so he blamed me for making stuff up, and stormed out of the exam room.  I had studied Nutrition before earning a degree in Microbiology.  I switched because I was curious what vitamins from our food were doing in our bodies.  Vitamins are substances that our bodies cannot manufacture, so we must ingest them every day.  Without them, our bodies cannot manufacture life sustaining enzymes and we sicken and die.   At home alone, I could feel myself dying.  It's an unnerving feeling, to say the least, and, so, with nothing left to lose, I relied in my education in nutrition.  My symptoms of Thiamine deficiency were the worst, so I began taking high dose Thiamine.  I had health improvement within an hour.  It was magical.  I continued taking high dose thiamine with a B Complex, magnesium. and other essential nutrients.  The health improvements continued for months.  High doses of thiamine are required to correct a thiamine deficiency because thiamine affects every cell and mitochondria in our bodies.    A twenty percent increase in dietary thiamine causes an eighty percent increase in brain function.  The cerebellum of the brain is most affected.  The cerebellum controls things we don't have to consciously have to think about, like digestion, balance, breathing, blood pressure, heart rate, hormone regulation, and many more.  Thiamine is absorbed from the digestive tract and sent to the most important organs like the brain and the heart.  This leaves the digestive tract depleted of Thiamine and symptoms of Gastrointestinal Beriberi, a thiamine deficiency localized in the digestive system, begin to appear.  Symptoms of Gastrointestinal Beriberi include anxiety, depression, chronic fatigue, headaches, Gerd, acid reflux, gas, slow stomach emptying, gastroparesis, bloating, diarrhea and/or constipation, incontinence, abdominal pain, IBS,  SIBO, POTS, high blood pressure, heart rate changes like tachycardia, difficulty swallowing, Barrett's Esophagus, peripheral neuropathy, and more. Doctors are only taught about thiamine deficiency in alcoholism and look for the classic triad of symptoms (changes in gait, mental function, and nystagmus) but fail to realize that gastrointestinal symptoms can precede these symptoms by months.  All three classic triad of symptoms only appear in fifteen percent of patients, with most patients being diagnosed with thiamine deficiency post mortem.  I had all three but swore I didn't drink, so I was dismissed as "crazy" and sent home to die basically.   Yes, I understand how frustrating no answers from doctors can be.  I took OTC Thiamine Hydrochloride, and later thiamine in the forms TTFD (tetrahydrofurfuryl disulfide) and Benfotiamine to correct my thiamine deficiency.  I also took magnesium, needed by thiamine to make those life sustaining enzymes.  Thiamine interacts with each of the other B vitamins, so the other B vitamins must be supplemented as well.  Thiamine is safe and nontoxic even in high doses.   A doctor can administer high dose thiamine by IV along with the other B vitamins.  Again, Thiamine is safe and nontoxic even in high doses.  Thiamine should be given if only to rule Gastrointestinal Beriberi out as a cause of your symptoms.  If no improvement, no harm is done. Share the following link with your doctors.  Section Three is especially informative.  They need to be expand their knowledge about Thiamine and nutrition in Celiac Disease.  Ask for an Erythrocyte Transketolace Activity test for thiamine deficiency.  This test is more reliable than a blood test. Thiamine, gastrointestinal beriberi and acetylcholine signaling.  https://pmc.ncbi.nlm.nih.gov/articles/PMC12014454/ Best wishes!
    • Jmartes71
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