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Pre-Celiac? help w results


tribny

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tribny Newbie

I would really appreciate opinions from all of you who are familiar with these tests. 

My full results are below.  Just a quick summary. I had bad GERD so the GI doc did an endoscopy.  He saw small intestinal damage that looked like Celiac.  Biopsy results were "could be Celiac or lots of other things."  Then got blood tests that came back "susceptible" and "high" antibodies but not positive.  Dr told me to go gluten free so I don't develop Celiac.  I went gluten free for 3 months.  Didn't feel any different, I never had intestinal symptoms before anyway.  Dr said my GERD issues were unrelated to Celiac.  I got GERD  surgery and I am finally off PPIs.  I took an intolerance test that didn't list gluten.  So I have gluten occasionally now, still don't feel any symptoms.

Don't know why I had the villi damage.  Should I stay gluten free, get more allergy blood tests or did the PPIs cause this?  Here are my results.  Any opinions???  THANK YOU FOR YOUR INPUT

HLA DQ2 Present ABSENT Abnormal Final
HLA DQ8 Absent ABSENT Normal Final
METHODOLOGY: PCR followed by hybridization with membrane-bound DNA probes
and detection by streptavidin-peroxidase conjugate (strip test).

---------------------------------------------

TRANSGLUTAMINASE,IGA,AB 8.6 <7.0 ELiAU/mL High Final
RANGES FOR TRANSGLUTAMINASE AND GLIADIN DEAMIDATED PEPTIDE ANTIBODIES
IgA/IgG (EliA U/mL) INTERPRETATION
<7.0 Negative
7.0-10.0 Equivocal
>10.0 Positive
ASSAY INFORMATION: Method Fluoroenzymeimmunoassay (Phadia250).
New ranges effective 6/6/14

--------------------------

A. DUODENUM, SECOND PART, BIOPSY:
• DUODENAL MUCOSA WITH MILD PROMINENCE IN INTRAEPITHELIAL LYMPHOCYTES WITH
PRESERVED VILLOUS ARCHITECTURE. Mild prominence in intraepithelial lymphocytosis may be non-specific, and can be seen in partially treated or clinically latent celiac sprue, dermatitis herpetiformis, infectious gastroenteritis, stasis, tropical
sprue, lymphocytic enterocolitis, and other protein allergies, in patients with other autoimmune disorders,
idiopathic inflammatory bowel disease, and may be linked to use of non-steroidal anti-inflammatory drugs
and Helicobacter pylori infection. Clinical and endoscopic correlation is needed. A special stain (Alcian
Blue/PAS) to identify Whipple's disease is negative, and no parasites are seen.

B. DUODENUM, BULB, BIOPSY:
• MINUTE SUPERFICIAL FRAGMENTS OF DUODENAL MUCOSA WITH MILD INCREASE IN
INTRAEPITHELIAL L YMPHOCVTES.• PLEASE SEE THE NOTE UNDER PART A.

C. STOMACH, ANTRUM, BIOPSY: ·GASTRIC ANTRAL MUCOSA WITH MILD REACTIVE GASTROPATHY.
Note: A special stain (Alcian Blue/PAS) shows no evidence of intestinal metaplasia. A separate special
stain (Giemsa) shows no evidence of Helicobacter pylori organisms.

D. STOMACH, BODY, BIOPSY:  • GASTRIC OXYNTIC MUCOSA WITH FOVEOLAR HYPERPLASIA AND INCREASED CHRONIC
INFLAMMATION.  Note: A special stain (Alcian Blue/PAS) shows no evidence of intestinal metaplasia. A separate special
stain (Giemsa) shows no evidence of Helicobacter pylori organisms.

E. STOMACH, FUNDUS, BIOPSY:
- GASTRIC OXYNTIC MUCOSA WITH CHANGES SUGGESTIVE OF PROTON PUMP INHIBITOR (PPI)
THERAPY EFFECT.  Note: A special stain (Alcian Blue/PAS) shows no evidence of intestinal metaplasia. A separate special
stain (Giemsa) shows no evidence of Helicobacter pylori organisms.

F. ESOPHAGUS, 35 CM, BIOPSY:  - FRAGMENTS OF SQUAMOUS MUCOSA WITH MILD REACTIVE EPITHELIAL CHANGE.
Note: No fungi are seen on PAS/AB stain. No columnar-type mucosa is present. There is no evidence of
eosinophilic esophagitis.

G. ESOPHAGUS, 25 CM, BIOPSY:  - FRAGMENTS OF SQUAMOUS MUCOSA WITHIN NORMAL LIMITS.
Note: No fungi are seen on PAS/AB stain. No columnar-type mucosa is present. There is no evidence of
eosinophilic esophagitis.


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cyclinglady Grand Master

I am sorry that you are in "Limbo Land!"  

Hard to say, from my own personal experience, I only test postive to the DGP.   What were your DGP results?  Negative?  Are you IGA deficient?  Any other AI disorders?   Besides the GERD, any other symptoms not GI related like anemia?  

I suppose you could continue to consume gluten until you develop symptoms (and do not live in fear!)  It is a shame that you have to be really damaged to get a diagnosis, but you should celebrate the fact that your GERD has resolved!   I wish you well!  

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    • trents
      @KRipple, thank you for the lab results from your husband's celiac disease blood antibody testing. The lab result you share would seem to be the tTG-IGA (Tissue Transglutaminase IGA) and the test result is in excess of 10x normal. This is significant as there is an increasing tendency for physicians to grant a celiac disease diagnosis on the basis of antibody testing alone when the scores on that particular test exceed 10x normal. This trend started in the UK during the COVID pandemic when there was tremendous pressure on the medical system over there and it has spread to the USA. The tTG-IGA is the centerpiece of celiac disease blood antibody testing. All this to say that some doctors would grant a celiac disease diagnosis on your husband's bloodwork alone and not feel a need to go forward with an endoscopy with biopsy. This is something you and your husband might wish to take up with his physicians. In view of his many health issues it might be wise to avoid any further damage to his small bowel lining by the continuing consumption of gluten and also to allow healing of such to progress. The lining of the small bowel is the place where essentially all of our nutrition is absorbed. This is why celiac disease when it is not addressed with a gluten free diet for many years typically results in additional health problems that are tied to nutritional deficiencies. The millions and millions of tiny finger-like projections that make up the nutrient absorbing surface of the small bowel lining are worn down by the constant inflammation from gluten consumption. In celiac disease, the immune system has been tricked into labeling gluten as an invader. As these finger-like projections are worn down, the efficiency of nutrient absorption becomes more and more compromised. We call this villous atrophy.   
    • KRipple
      Thank you so much! And sorry for not responding sooner. I've been scouring the hospital records and can find nothing other than the following results (no lab info provided): Component Transglutaminase IgA   Normal Range: 0 - 15.0 U/mL >250.0 U/mL High   We live in Olympia, WA and I will be calling University of Washington Hospital - Roosevelt in Seattle first thing tomorrow. They seem to be the most knowledgeable about complex endocrine issues like APS 2 (and perhaps the dynamics of how APS 2 and Celiacs can affect each other). His diarrhea has not abated even without eating gluten, but that could be a presentation of either Celiac's or Addison's. So complicated. We don't have a date for endoscopy yet. I will let my husband know about resuming gluten.    Again, thank you so much for sharing your knowledge with me!
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    • aattana
      Hi Phosphone, did you ever figure out what elevated your DGP?  I am in the same boat. 
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      Scott makes a good point about the prednisone. It has a general suppressing effect on the immune system. Don't misunderstand me. In view of your husband's several autoimmune afflictions, it would seem to be an appropriate medication therapy but it will likely invalidate endoscopy/biopsy test results for celiac disease.
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