Needing Info On Enterolab Results

[newgfmommy]

Hi! I am new to this site and have never posted anywhere before, so hope this is the right way to do it! Anyway, I was hoping someone could help me sort out the results we received from Enterolab for my 2 and a half yr. old son. Just a quick background: He has been on the WF,gluten-free diet for 3 months, after going to a Ped. GI doc who ran some antibody tests. The tests came back negative, but the doc still wanted to do biopsies, which we declined at his age. At that point we started him on the diet and he has gained weight, not complained as much (still some) and his stools are better. My main questions about his tests are:

Why would he have such a high malabsorption score?

Does this tell us he has alot of damage as well?

Also, if he has both gluten sensitivity genes, but not the predisposed Celiac gene do we treat it the same as if he has celiac, or not?

Should my husband and I and our daughter get tested, or not?

I am also expecting our third child and wondering if I should go gluten-free?

Finally, how long should he go without dairy, or do these results show a lifelong intolerance to that as well?

SO MANY QUESTIONS, thank you for taking the time to look them all over.

Here are the test results:

Fecal Antigliadin IgA 51 (Normal Range <10 Units)

Fecal Antitissue Transglutaminase IgA 21 Units (Normal Range <10 Units)

Quantitative Microscopic Fecal Fat Score 1254 Units (Normal Range <300 Units)

Fecal anti-casein (cow's milk) IgA antibody 19 Units (Normal Range <10 Units)

HLA-DQB1 Molecular analysis, Allele 1 0303

HLA-DQB1 Molecular analysis, Allele 2 0602

Serologic equivalent: HLA-DQ 3,1 (Subtype 9,6)

Interpretation of Fecal Antigliadin IgA: Intestinal antigliadin IgA antibody was elevated, indicating that you have active dietary gluten sensitivity. For optimal health, resolution of symptoms (if you have them), and prevention of small intestinal damage and malnutrition, osteoporosis, and damage to other tissues (like nerves, brain, joints, muscles, thyroid, pancreas, other glands, skin, liver, spleen, among others), it is recommended that you follow a strict and permanent gluten free diet. As gluten sensitivity is a genetic syndrome, you may want to have your relatives screened as well.

Interpretation of Fecal Antitissue Transglutaminase IgA: You have an autoimmune reaction to the human enzyme tissue transglutaminase, secondary to dietary gluten sensitivity.

Interpretation of Quantitative Microscopic Fecal Fat Score: A fecal fat score greater than or equal to 300 Units indicates there is an increased amount of dietary fat in the stool which usually is due to gluten-induced small intestinal malabsorption/damage when associated with gluten sensitivity. Values between 300-600 Units are mild elevations, 600-1000 Units moderate elevations, and values greater than 1000 Units are severe elevations. Any elevated fecal fat value should be rechecked in one year after treatment to ensure that it does not persist because chronic fat malabsorption is associated with osteoporosis among other nutritional deficiency syndromes.

Interpretation of Fecal anti-casein (cow's milk) IgA antibody: Levels of fecal IgA antibody to a food antigen greater than or equal to 10 are indicative of an immune reaction, and hence immunologic "sensitivity" to that food. For any elevated fecal antibody level, it is recommended to remove that food from your diet. Values less than 10 indicate there currently is minimal or no reaction to that food and hence, no direct evidence of food sensitivity to that specific food. However, because 1 in 500 people cannot make IgA at all, and rarely, some people can still have clinically significant reactions to a food antigen despite the lack of a significant antibody reaction (because the reactions primarily involve T cells), if you have an immune syndrome or symptoms associated with food sensitivity, it is recommended that you try a strict removal of suspect foods from your diet for up to 12 months despite a negative test.

Interpretation Of HLA-DQ Testing: Although you do not possess the main HLA-DQB1 genes predisposing to celiac sprue (HLA-DQB1*0201 or HLA-DQB1*0302), HLA gene analysis reveals that you have two copies of a gene that predisposes to gluten sensitivity (any DQ1, DQ2 not by HLA-DQB1*0201, or DQ3 not by HLA-DQB1*0302). Having two copies of a gluten sensitive gene means that each of your parents and all of your children (if you have them) will possess at least one copy of the gene. Two copies also means there is an even stronger predisposition to gluten sensitivity than having one gene and the resultant immunologic gluten sensitivity may be more severe.

[nora-n]

hi, there have been a couple diagnised celiacs here with DQ6. And some DQ9 who were pretty ill on glten.

The enterolab results were pretty positive for gluten intolerance.

nora

[ShayFL]

Looks pretty SEVERE. Make sure you are keeping him 100% gluten-free and cut out the Dairy right now too. In 3 months try reintroducing dairy and see what happens. I would personally go ahead and cut out Soy too if he doesnt get better gluten-free and Dairy Free.

No Wheat, Barley, Rye, Oats or Dairy. Then see where you are in 3 months.

[mftnchn]

I'd agree that it looks pretty severe, both gluten indexes clearly positive and very severe malabsorption.

Based on my own experience (my malabsorption score was over 1300), I'd see if you can get further testing to check malabsorption of proteins and carbohydrates; maybe wait three months as mentioned above and see if he is improving noticeably. Enterolab only checks fat absorption, my doctor said he needed to check the rest too. It turned out that I was not digesting most carbs and that kept me from getting well even after months of gluten-free, CF, and SF. Removing those carbs from my diet has helped IMMENSELY, and now I need to wait another year probably to see if I'll heal enough to put some back into my diet.

Keep in mind that in the compromised state of his gut, the more easily digestible food you give him the more good he'll get from it.

You'd probably only get a clear diagnosis of celiac with villi atrophy (biopsy proven). But essentially his response to gluten means you have to treat it just like celiac.

If I were you, I would test the family, and if one of you has similar results, get the full work-up with biopsy. If you or your husband are confirmed celiac, the evidence mounts greatly. There are cases of celiac without the main genes.

Whether you can successfully reintroduce dairy varies much and we can't predict that for you. He has a milk protein sensitivity (like an allergy) not just a lactose intolerance. AFter gluten-free some people notice more sensitivities, some people's sensitivities go down, some people's go up then eventually back down. I'd take it out for now and be very strict about it.

[nora-n]

There is a SCD thread about those carb issues here in the other food intolerance and leaky gut issues folder here on this forum.

[newgfmommy]

  nora_n said:

There is a SCD thread about those carb issues here in the other food intolerance and leaky gut issues folder here on this forum.

Thank you to all who gave me a response. I am still overwhelmed with it all, but know now which steps to take to move forward with this. Thanks again!