Hive MD interpreting Celiac bloodwork

[cintinative]

My husband's iron is dropping week over week. Since my son has Celiac, they tested my husband (again, they did this many years ago as well). The GP basically wouldn't comment on what it meant and is referring us to GI. The GI can't get him in until Nov. (ETA: Found another group that can get him in next Tues).  It would help if we had some idea if this was Celiac or internal bleeding.  Does anyone know enough to comment?  My other son had high TtG readings but the Endomysial IgA negative makes things more complicated. Thanks in advance Hive.

ETA: found a flow chart and I think he is a positive. https://www.mayocliniclabs.com/-/media/it-mmfiles/Special-Instructions/5/F/8/Celiac_Disease_Diagnostic_Testing_Algorithm

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Gliadin IgA 16 units (in normal range)

Gliadin IgG 35 units (high)

IgA. 169 (in normal range)

Transglutaminase IgA 3 U/mL (normal 0 to 3 U/mL)

Endomysial IgA negative

Deaminated Gliadin Abs IgG 35 (positive)

Edited July 24 by cintinative

[Martha in GA]

I have no idea, but I hope you can get answers before November!

[Ann.without.an.e]

Did he have any other labs done? A CBC? ESR? CRP?

 

ETA: I ask because celiacs and crohns/UC are "cousins" and your son having one means you, your husband, and his siblings have a 40% higher change of getting crohns/UC/Celiacs. It could be that he is sending him with concerns about UC or Crohn's. 

Edited July 24 by Ann.without.an.e

[prairiewindmomma]

Since the intake is several months out, I’d call GI and ask if dh can go GF now or if he needs to wait. If they ask him to wait, I’d ask if he can do any bloodwork or biopsies now and then go GF. Fwiw, even if you get nos to all of that, ask if he can go onto the workin list. 
 

 

 

[cintinative]

3 minutes ago, Ann.without.an.e said:

Did he have any other labs done? A CBC? ESR? CRP?

 

ETA: I ask because celiacs and crohns/UC are "cousins" and your son having one means you, your husband, and his siblings have a 40% higher change of getting crohns/UC/Celiacs. It could be that he is sending him with concerns about UC or Crohn's. 

His sister has Crohn's.  The only other results I have from him are his iron.  I will ask about those.

 

[cintinative]

So from the whole blood labs

WBC low end normal

RBC low end normal

Hemoglobin low 

Hematocrit Low

MCV & MCH lowest end of normal

RDW high

Platelets normal

MPV normal

MCHC normal

Monocytes Relative- high

Basophils Relative -high end of normal

Lymphocytes absolute - low end of normal

[kbutton]

2 hours ago, cintinative said:

The GI can't get him in until Nov. It would help if we had some idea if this was Celiac or internal bleeding

That’s a long wait. Is the GP going to monitor the iron in the meantime? Do you have instructions about what to look for that would be ER worthy?

I hope they can get the ball rolling during the waiting period!

Is an allergist another way to get this interpreted? That might also be a wait, but maybe it would be quicker.

 

[cintinative]

7 minutes ago, kbutton said:

That’s a long wait. Is the GP going to monitor the iron in the meantime? Do you have instructions about what to look for that would be ER worthy?

I hope they can get the ball rolling during the waiting period!

Is an allergist another way to get this interpreted? That might also be a wait, but maybe it would be quicker.

 

No allergist. So the wait would be nearly as long.

He tried a second GI doc and that person was booked until October.  I told him to try mine.  I see a CNP but there is a surgeon she works with. It is often easier to see her. 

Considering the doctor didn't initiate contact on the results before my husband, I am not sure I trust that the doc will stay on top of it. Hopefully he can get into see the CNP. 

[prairiewindmomma]

Is he of the age/time frame where he could get a colonoscopy? That’d be another way to kind of jump the line. The colonoscopy GI drs here have a different scheduling wait time than the “problem” GI doctors. Odds are with a family history of Crohn’s that that’s the next step if he hasnt had a recent scope done.

[cintinative]

6 minutes ago, prairiewindmomma said:

Is he of the age/time frame where he could get a colonoscopy? That’d be another way to kind of jump the line. The colonoscopy GI drs here have a different scheduling wait time than the “problem” GI doctors. Odds are with a family history of Crohn’s that that’s the next step if he hasnt had a recent scope done.

He isn't due for his routine colonoscopy.  I was just able to schedule him with a GI on Tuesday of next week. I don't know if that person even does procedures but at least it gets him in the door. We both think he will need an upper/lower GI but we'll see.