Bloodwork....

[prairiemamma]

How accurate is the Celiac panel bloodwork? My son's bloodwork is positive. His tTG was 1.5 but the DGP? Is 35.1. The pedestrian doesn't want to send him for a biopsy quite yet. He just turned 4 and has other special needs and he doesn't want to have to put him through the biopsy if he doesn't have to. He put him on the gluten-free diet immediately for a 3m trial, and will rerun the bloodwork. If I see significant improvement in the next few weeks, he wants to do the biopsy.

So can you have positive bloodwork like his and not have celiac? Sounds like a sure thing to me, but maybe I'm wrong.

[mushroom]

The DGP is pretty specific for celiac disease. I would say the chances he has it are about 99%

[rosetapper23]

Why would the pediatrician want to do a biopsy after a few weeks on a gluten-free diet? That makes no sense! If there's an improvement on the diet, then your child has celiac. Even if there is no improvement in symptoms yet, his intestinal lining could heal enough after a few weeks so that the biopsy would come out negative anyway. It's pointless.

[Takala]

The longer the kid stays on a gluten free diet, the less likely is a positive biopsy which would give a definite diagnosis because he or she may in that time begin to heal..... waiting for the biopsy does not make any sense.

Now, if your child is on the gluten free diet faithfully, you see improvements in symptoms, AND his bloodwork shows an improvement towards that of a normal person, (drop in antibodies to gluten) then that would mean that is it also highly likely he/she is celiac. And if the doctor is willing to diagnose formally just on that, that is fine. It's when they do it half-@$$3d, like waiting months after the start of the gluten-free diet, and then biopsying and declaring that "nope, it can't be celiac" that it gets ridiculous.

The only reason to do a biopsy would be to look for "other things wrong" if the diet didn't seem to be working.

Hopefully the doctor also said try to cut lactose out (at least temporarily) because celiac damage also hinders the ability to digest milk sugars... this ability may come back after awhile on the diet. Milk and soy seem to be the 2 big "other" categories of foods that can bother celiacs.

[MitziG]

Agreed. It would be a bad idea to biopsy after he has been gluten-free even a few weeks. Children heal quickly, and the biopsy looks for damage. If they see no damage, they will tell you he doesn't have celiac, when in reality, he just healed.

The blood tests are very accurate. If your doc won't biopsy now, get him to agree to dx him based on a positive response to a gluten-free diet and improved bloodwork after being gluten-free. His antibodies should drop significantly within a few months. Then you have your rreal answer.

[prairiemamma]

Agreed. It would be a bad idea to biopsy after he has been gluten-free even a few weeks. Children heal quickly, and the biopsy looks for damage. If they see no damage, they will tell you he doesn't have celiac, when in reality, he just healed.

The blood tests are very accurate. If your doc won't biopsy now, get him to agree to dx him based on a positive response to a gluten-free diet and improved bloodwork after being gluten-free. His antibodies should drop significantly within a few months. Then you have your rreal answer.

That is exactly what I'm going to do. (go on bloodwork after being gluten-free). So, how long do you think it would take for his antibodies to drop? Do you think 3 months is long enough or would they drop sooner/later?