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3 Yr Follow-Up Biopsy: Positive Dgp Iga Negative Biospy


gfcolorado

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gfcolorado Newbie

Here is my background:

Diagnosed 3 years ago with positive TTG and EMA and Marsch 3c biopsy.

At 1 and 2 years, celiac tests were normal.

Just had 3 year test and TTG IGA and IGG, EMA and DGP IGG were negative but DGP IGA was positive (61). Decided to get biopsy since I have minimal symptoms and don't really know for sure when I am glutened. My GI took 9 samples. Here are results:

WHOLE EXAMINED DUODENUM, BIOPSY

Histologically normal duodenal mucosa.

No histologic evidence of celiac sprue (there are up to 8 intraephithelial lymphocytes per 100 epithelial cells).

CommentL Tryptase immunostain negative for increased mast cells (average of 6mast cells over 10 high power fields).

So my understanding is that I'm completely healed but don't know what the report really means. Anyone know?

My doctor now thinks that my DGP was high because I probably had gluten contamination; however, before the endoscopy both he and the test manufacturer thought I was getting continued gluten exposure. I tested everything and couldn't find anything so I'm very relieved. Hope this helps people with DGP questions.

Thanks!


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Mari Enthusiast

I did a search for 'dgp iga' Here's one result:

Positive Deamidated Gliadin Peptide Antibodies and Negative Tissue ...

Mar 31, 2010

ravenwoodglass Mentor

Since you are still having mild problems you may have some gluten sneaking in somewhere. It could be toiletries, pet food, processed foods that are CC'd in the plant, a significant other who eats gluten and doesn't brush teeth before kissing etc. Also be sure you are checking all meds both script and OTC. If you take any generic meds those should be checked at each refill as the binders can be changed at will. Supplements can have a gluten free label and still have barley or wheat grass so make sure you read the whole label on those. When calling on scripts I always say I have a wheat allergy as wheat starch is considered gluten free.

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    • trents
      Let me hasten to add that if you will be undergoing an endoscopy/biopsy, it is critical that you do not begin efforts to reduce gluten beforehand. Doing so will render the results invalid as it will allow the small bowel lining to heal and, therefore, obscure the damage done by celiac disease which is what the biopsy is looking for.
    • Scott Adams
      This article, and the comments below it, may be helpful:    
    • Scott Adams
      That’s a really tough situation. A few key points: as mentioned, a gluten challenge does require daily gluten for several weeks to make blood tests meaningful, but negative tests after limited exposure aren’t reliable. Dermatitis herpetiformis can also be tricky to diagnose unless the biopsy is taken from normal-looking skin next to a lesion. Some people with celiac or DH don’t react every time they’re exposed, so lack of symptoms doesn’t rule it out. Given your history and family cancer risk, this is something I’d strongly discuss with a celiac-experienced gastroenterologist or dermatologist before attempting a challenge on your own, so risks and benefits are clearly weighed.
    • Greymo
      https://celiac.org/glutenexposuremarkers/    yes, two hours after accidents ingesting gluten I am vomiting and then diarrhea- then exhaustion and a headache. see the article above- There is research that shows our reactions.
    • trents
      Concerning the EMA positive result, the EMA was the original blood test developed to detect celiac disease and has largely been replaced by the tTG-IGA which has a similar reliability confidence but is much less expensive to run. Yes, a positive EMA is very strong evidence of celiac disease but not foolproof. In the UK, a tTG-IGA score that is 10x normal or greater will often result in foregoing the endoscopy/biopsy. Weaker positives on the tTG-IGA still trigger the endoscopy/biopsy. That protocol is being considered in the US but is not yet in place.
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