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Help Interpreting Child #2's Blood Test Results

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Hi again. I'm back with my younger daughter's blood test results. (I started a post a few weeks ago about our older daughter who had very positive blood test results but a negative biopsy and negative results for the DQ2 & DQ8 genes). We decided to go ahead and ask the pediatrician to do a Celiac panel since our house is quickly becoming gluten-free due to my husband also finally accepting that he has a gluten problem. Also, I read Wheat Belly and it scared the daylights out of me. Anyway, this daughter seems asymptomatic except that she's never had as much energy as it seems she should, occasional headaches, PMS, and her iron level is now just a tad below normal. We got the test results today and here's how they look:

Celiac Disease Ab Evaluation:

tTg Ab, IgA: 22.4 (<20 negative; 20-25 Equivocal)

Gliadin Peptide Ab, IgG: 10.3 (<20 Negative)

Gliadin Peptide Ab, IgA: 28.3 (<20 Negative, 20-25 Equivocal, >25 Positive).

So even after all the reading I've done, I'm still confused about the Gliadin Peptide tests - if these are the old ones that really aren't accurate, or if they are useful. Can anyone tell me?? Any thoughts on the above test results?

I'm waiting for the pediatrician to call me back to discuss whether or not this daughter should see a pediatric GI or an adult GI since she'll be 18 in a few months. I'm actually feeling conflicted about whether or not she even needs to see a GI except that she'll be going away to college next year and will probably need some kind of doctor's orders for gluten-free dining. (Dh is worried though that giving her a Celiac diagnosis when she might not have it will come back to haunt her when she tries to get life insurance or disability insurance. I guess that's a question for another post.)

The GI older daughter saw is the one who said not to bother having siblings tested unless they were experiencing obvious symptoms and who, after the negative biopsy and gene tests, told us that she probably does not have Celiac Disease and so not to worry about cross-contamination anymore, though she must be gluten sensitive. I'm actually not certain that we trust him now, though he's a nice enough guy. Again, after all the reading I've done, I know that it is possible to have gluten cause as many problems in a gluten sensitive person as it does in someone with Celiac Disease (minus the small intestine damage), so we feel the most important thing is to just go gluten-free if we know gluten is causing problems.

So I'm floundering here. I guess my questions are:

1) can anyone help me interpret these blood test results?

2) any thoughts on a pediatic vs adult GI for an almost 18-yo?

3) do we just reject the endoscopy and genetic tests with this daughter and wing it?

Thanks!

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Your daughter's tTG is in the equivocal range, but her DGP (here called Gliadin Peptide) is positive for celiac. The DGP is the newest and probably the most specific for celiac disease.

If I were you, since your daughter is on the verge of adulthood, I would have her see a regular gastroenterologist rather than a pediatrics GI. She is entering a new phase of life and this will (hopefully) be a doctor to travel with her in the future.

Is it possible that daughter No.1's endoscopy was a false negative? How many biopsy samples did they take? Since the disease is often patchy in distribution it is recommended that at least six be taken. Make sure they do this for daughter No.2. The genetic testing is not decisive in that other genes elsewhere in the world have been associated with celiac disease and there are posters with a celiac diagnosis on the forum who possess other genes; they are just not nearly as common as DQ2 and DQ8.

If you do not want to do the endoscopy for your daughter, in view of your husband's reaction to gluten also, (makes sense since it is a genetic disease) I think I would just take the family gluten free and see how well they respond to the diet. If your daughter is going to college, however, she will need a doctor's note, so you have to be sure that the GI will give her the appropriate documentation to get her out of the regular meal plan; i.e., will he diagnose on the basis of blood tests or will he only diagnose with positive biopsy.

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