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Update - High DGA IgG Bloodwork, Got Biopsy Results


PrismagicMushroom

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PrismagicMushroom Rookie

Good news for the people who saw my last post. My biopsy went without a hitch and I've already got the results back a week later! 

Bad news....I have no idea what's going on anymore. I'm posting here just in case anyone else ever has a similar issue, so there's something that comes up in the site search.

As a refresh, here's the bloodwork from my rheumatologist that started everything (c/o Labcorp):

                   Name                            |     Result          |     Typical Range

Deamidated Gliadin Abs, IgA    |    4 units          |      0-19 units

Deamidated Gliadin Abs, IgG    | [H]  29 units  |      0-19 units

t-Transglutaminase (tTG) IgA    |    <2 U/mL       |      0-3 U/mL

t-Transglutaminase (tTG) IgG    |   <2 U/mL        |      0-5 U/mL  

Endomysial Antibody IgA         |   Negative        |      Negative

Immunoglobulin A, Qn, Serum |  278 mg/dL     |      87-352

 

My gastroenterologist decided that, with that result combined with my longstanding intestinal discomfort, it was worth doing the celiac biopsy even though he didn't seem convinced it would come back positive. He took 4 sample groups: two randomly placed duodenum, 1 lower stomach, and 1 esophageal. These results also came from Labcorp.

Samples 1 and 2 from the duodenum have the same results listed: "2-Duodenal mucosa shows preserved villous architecture and normal cellularity of the lamina propria. Brunner glands are identified. No gastric metaplasia is seen. No dysplasia or malignancy is identified. There are no viral inclusions. No Giardia, other parasites or other pathogenic organisms are seen. No Helicobacter pylori organisms are identified."

Sample 3 from the stomach lining: "3-Gastric mucosa shows moderately increased lymphoplasmacytic cells in the lamina propria. Focal neutrophilic activity is identified. No intestinal metaplasia is seen."

Sample 4 from the esophagus says: "4-Gastric-type mucosa shows a lymphoplasmacytic infiltrate in the lamina propria. Neutrophilic activity is not identified. No specialized epithelium of Barrett's is identified."

---

Of course, when I google the things mentioned in samples 3 and 4, one of the things that comes up is that it's a symptom sometimes associated with celiac, though it's usually alongside villi damage, not instead of it. The most common cause appears to be long term NSAID use, but I have only been using NSAIDs daily for a few weeks, per my rheumatologist's preference to try non-steroidal approaches to inflammation as a first resort. I have been having most of my symptoms for years! And the other symptoms I have have been ramping up since January....nothing's changed in the last 6 weeks except that sometimes my joints hurt less thanks to the naproxen prescription.

My gastro follow up isn't until exactly a month from today, so I'm going to call and see if any cancellations open up. I'll post a final update once I see him and get his actual professional opinion.


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Scott Adams Grand Master

I don't recall all info from your last posts, but hopefully you were eating ~2 slices of bread's worth of gluten daily for 2 weeks before the endoscopy, and at least 6 weeks before the blood tests. 

You do have one positive blood test result, and you can find out more about what that means in the article below.

It could be that you have non-celiac gluten sensitivity, for which there currently isn't a test, yet ~10x more people have it, and a gluten-free diet is also the treatment. If your symptoms go away on a gluten-free diet then you likely have your answer. Also see the other article posted below, it's older, but very good.

 

 

Victor2022 Rookie

What i am observing is this trend (with or without a symptom) that everything else is negative and "Deamidated Gliadin , IgG" is coming positive for many and most are relating this to celiac (even if tTG-IgA is within range & Total IGA is normal). Firstly why this test is prescribed, if it creates confusion, again i am seeing a trend that in many instance people go to lengths and find out no celiac/ non determined/nothing. Second: its sure that Antibodies are there so why they are there? what i think for gluten sensitivity/allergy there should not be a antibody. So for what these antibodies are generating or there is something else?

Scott Adams Grand Master

From the article I posted:

Quote

The sensitivity of the DGP-IgG test is reported to range from 75% to 85%, which means it can correctly identify individuals with the condition in about 75% to 85% of cases. The specificity of the DGP-IgG test is reported to range from 75% to 95%, which means it can correctly identify individuals without the condition in about 75% to 95% of cases.

 

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    • trents
      But isn't it easier to just take a D3 supplement? Is the D light somehow a superior source? Links?
    • Scott Adams
      So the way it should be used is to take it before possible gluten exposure, so right before a meal at a restaurant take 1-2 capsules. Unfortunately taking it 1 hour or more after an exposure is too late.
    • Scott Adams
      Welcome to the forum, and thank you for sharing your detailed experience. It sounds like you’ve been through a lot over the past several months, and it’s understandable to feel frustrated after navigating unclear diagnoses and conflicting advice. Since you’ve found relief with a gluten- and corn-free diet, it might be worth continuing that approach for now, especially given your current commitments to culinary classes. You could consider working with a knowledgeable dietitian or a gastroenterologist who specializes in food intolerances and celiac disease to explore potential intolerances or other conditions without immediately reintroducing gluten. If confirming celiac disease is important for your long-term health management, you could plan for an endoscopy during a less busy period, ensuring you follow the gluten challenge protocol beforehand. In the meantime, prioritizing your well-being and avoiding known triggers seems like a practical step. Always advocate for yourself with doctors, and seek second opinions if needed—your health concerns are valid. Many people with celiac disease, especially those who are in the 0-2 year range of their recovery, have additional food intolerance issues which could be temporary. To figure this out you may need to keep a food diary and do an elimination diet over a few months. Some common food intolerance issues are dairy/casein, eggs, corn, oats, and soy. The good news is that after your gut heals (for most people who are 100% gluten-free this will take several months to two years) you may be able to slowly add some these items back into your diet after the damaged villi heal. This article may be helpful:    
    • trents
      Welcome to the forum, @Ryangf! If you don't have celiac disease you could still have NCGS (Non Celiac Gluten Sensitivity). They share many of the same symptoms but NCGS does not damage the lining of the small bowel as does celiac disease. Some experts feel NCGS can be a precursor to the development of celiac disease. NCGS is 10x more common than celiac disease. There is no test for it. A diagnosis of NCGS is arrived at by first ruling out celiac disease by formal testing. At the end of the day the antidote for both is the same, namely, life-long abstinence from gluten. Yes, corn is a common cross-reactor with gluten for some celiacs. So are oats, soy, eggs and dairy.  I have concern with your possible exposure to wheat flour dust during your culinary training. It gets in the air, you breathe it in, it gets trapped in the mucous of your mouth and airway and winds up in your gut. If you decide to go forward wit the "gluten challenge" for formal celiac disease testing, aim for the daily consumption of 10g of gluten (about the amount in 4-6 slices of wheat bread) for four weeks leading up to the day of either the blood draw or the endoscopy/biopsy.
    • Scott Adams
      I just want to mention that with gluten we're talking about ppm, or "parts per million," and not parts per billion.  Sticking to whole foods and home cooking is the safest way to go, without necessarily replacing all gluten products you might normally eat with gluten-free ones. If you do eat gluten replacements, for example gluten-free bagels or breads, it's probably best to take @trents advice and seek out certified gluten-free brands.
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