Q & A
Return to ->Ask the Doctor->Tests and Their Results | QUESTION: I have celiac disease, diagnosed by biopsy and positive anti gliadin antibody test. My two year old son was borderline anemic at his 2 year check up despite the fact that he was taking iron supplements. The pediatrician sent anemia work up labs as well as anti tissue transglutaminase antibody. My son's ferritin was low and his antibody level was quite high. My pediatrician is recommending a biopsy. I am not certain a biopsy is needed. What else could give a positive ttg antibody, especially given a low ferritin and celiac parent? I realize there are ttg positive and biopsy negative patients, but I thought they eventually show villous atrophy on biopsies several years later. I don't want to misdiagnose my son, but I also would like to avoid a somewhat invasive procedure if it is not truly necessary. Thank you. | | DR. LEWIS: The decision to scope a child can be tough. You are right, the 2 year old probably does have celiac. I usually (but not always) scope in this setting because a positive biopsy is still considered to be the gold standard. You should probably sit down with the peds GI and discuss the pros and cons, especially before too long has passed on a gluten free diet. Once he has been on the diet long enough, the endoscopy won't be too helpful. Remember, it is a lifetime diagnosis that will affect his children as well so accuracy is important (although I would readily concede that if the ttg falls on a gluten free diet and the hemoglobin rises, that your son does have celiac). |
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