i have idiopathic gastroparesis (delayed gastric emptying with no known cause or trigger) and Hashimoto's thyroiditis (an autoimmune thyroid condition). my gliadin and tTg antibodies were not present and my duodenal biopsy showed norma villi functioning, so i have a conclusive "no" for celiac's disease.... but why is my IgA so high? ref range is 81-463 and mine is 613. this is my biopsy report from april. what does this indicate?
A. Duodenum, biopsy:
Duodenal mucosa with vascular congestion, focal minimal chronic inflammation
and preserved villous architecture.
B. Stomach, antrum, biopsy:
Gastric antral and fundic mucosa with mild chronic inflammation, vascular
congestion and mild reactive fibromuscular and foveolar hyperplasia, suggestive
of mild reactive gastropathy. No H Pylori organisms are seen with routine stain.
C. G.E. Juction, biopsy:
Gastric cardiac and fundic mucosa with edema and vascular congestion.
No intestinal metaplasia seen.
No squamous mucosa present. yes, i have seen an endocrinologist. i know quite a bit about my gastroparesis and hashimoto's already. my question was more directed at my elevated IgA levels and whether the results of my biopsy could help determine why my IgA is so high. Are you seeing an endocrinologist? here is what I found on the net..
Hashimoto鈥檚 thyroiditis
http://www.clinicaltrials.gov/ct/search?... (clinical trials...one with selenium..one with hep c relationship to hashimoto's, one with postpartum link)
http://en.wikipedia.org/wiki/Hashimoto's... (wikipedia)
http://www.nlm.nih.gov/medlineplus/ency/... (medline plus)
http://autoimmune.pathology.jhmi.edu/dis... (John Hopkins鈥ashimoto's thyroiditis is linked to sjorgren鈥檚 syndrome)
http://www.rarediseases.org/search/rdbde... (NORD..hypothyroidism鈥croll down for related organizations)
http://www.hormone.org/public/thyroid/hy... (the hormone foundation)
http://www.thyroid-info.com/hashimotos-e... (Hashimoto鈥檚 encephalopathy鈥are)
http://www.thyroid-info.com/articles/yer... (hashimoto鈥檚 and food borne infection,Yersinia enterocolitica infection, via contaminated meats -- especially raw or undercooked products -- poultry, unpasteurized milk and dairy products, seafood -- and particularly oysters -- from sewage-contaminated waters and produce fertilized with raw manure. Foods can also be contaminated by food handlers who have not effectively washed their hands before handling food or utensils used to prepare food. Improper storage can also contribute to contamination.>> stool test that can detect yersinia enterocolitica )
http://www.thyroid-info.com/articles/coh... (hashimoto鈥檚 and anergic depression)
http://thyroid.about.com/cs/hypothyroidi... (hashimoto鈥檚 vs hypothyroidism..what is the difference鈥?In the study of 21 patients with euthyroid Hashimoto's Thyroiditis (normal range TSH, but elevated antibodies), half of the patients were treated with levothyroxine for a year, the other half were not treated. After 1 year of therapy with levothyroxine, the antibody levels and lymphocytes (evidence of inflammation) decreased significantly only in the group receiving the medication. Among the untreated group, the antibody levels rose or remained the same.
The researchers concluded that preventative treatment of normal TSH range patients with Hashimoto's disease reduced the various markers of autoimmune thyroiditis, and speculated that that such treatment might even be able to stop the progression of Hashimoto's disease, or perhaps even prevent development of the hypothyroidism. )
http://thyroid.about.com/cs/hypothyroidi... (page 2鈥elenium might help鈥nd calcium with magnesium supplements for nighttime problems)
http://thyroid.about.com/cs/hashimotos/a... (hashimoto鈥檚 encephalopathy)
http://thyroid.about.com/od/hypothyroidi... (treating antibodies when TSH is normal)
http://thyroid.about.com/blcohen.htm (treating anergic depression)
3 books on disease symptoms and treatments
you could also get these books on ebay or amazon or a half price book store. (last two are very similar)..
1.Oxford Handbook of Clinical Medicine
2.Handbook of Diseases (Lippencott)
3.Professional Guide to Diseases (Springhouse) Are you sure you are not IGA or IGG deficient? What did the doctor tell you? (I'm impressed they looked for Celiac at all!)
I do not totally understand the medical jargon but it seems to say the villa are not flattened as in typical Celiac. As far as i know the IGA and IGG levels only rise in someone whose antibodies are fighting somethign, such as gluten, that they cannot tolerate. Perhaps you jsut have gluten intolerance, not full blown CD. Perhaps the damage wasnt long enough to get the villa. If you were not eating Gluten at the time of the blood test or endoscopy, any results will be wrong.
IGA isnt just to do with Celiac, they need to be looking at the specific Celiac antibodies such as:
A number of tests, sometimes collectively referred to as the Celiac Blood Panel, will aid the physician in diagnosis. The tests may include, but are not limited to:
*
Serologic Tests
1. EMA (Immunoglobulin A anti-endomysium antibodies)
2. AGA (IgA anti-gliadin antibodies)
3. AGG (IgG anti-gliadin antibodies)
4. tTGA (IgA anti-tissue transglutaminase)
* Tolerance or Measure of Digestion/Absorption Tests
1. Lactose tolerance test.
2. D-Xylose test.
If they did not do the blood test correctly Iwhich is certainly known to happen) then the test will be inconclusive.
I suggest speaking to your doc, and ask what is his opinion.
If you feel you could have CD and were incorrectly diagnosed, a genetic test can help. It is about 98% sure that ppl with the genes for Celiac (DQ2 and DQ8 most commony) will have Celiac triggered at some ponit in their lives. Just a few percent get Celiac and do not have the genes (and i question whether that is true Celiac.) Genetic testign can be done by your doc or through home tests.
MMM i'm intrigued by the situation, do let me know what the answer is!!!:)
Amy
Chairperson La North Shore Celiac Sprue Association |
