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Dh?


redheadheather

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redheadheather Explorer

Do you have to have a complete "outbreak" of DH to be tested for it? I believe DS has/had it (he is + for gluten intolerance).

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frenchiemama Collaborator

The way understand it, the IgA deposits remain in the skin for months or even years after going gluten-free. So they should still be able to take a biopsy.

lovegrov Collaborator

My understanding is that you have to have an active outbreak before they can take a biopsy sample.

richard

frenchiemama Collaborator

Well, I've been looking it up and everything I find says that the biopsy should be taken from normal skin but nothing specifies whether or not there needs to be an active breakout. You should probably talk to a doctor to find out for sure, but if you're interested here are a couple of articles that I found:

"Dermatitis herpetiformis is diagnosed by a special skin test. A very small piece of skin is taken under a local anaesthetic as an outpatient procedure. The test is carried out on skin NOT affected by the rash."

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"The diagnosis of DH is made by a simple skin test. A small piece of skin approximately 3 mms in diameter is taken from an unaffected area, ie. normal looking skin. The skin is examined for the presence of a substance called IgA (immunoglobulin A) and is found at a specific site in the skin. Although the test is simple, it is important a laboratory experienced in the procedure undertakes the examination of the skin. "

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Hope that helps.

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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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