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Hi Gang,
Here's a brief summary of my question on testing/websites. Sorry it took so
long to summarize. Work lately has had me swamped!
Previously, I wrote:
I am an undiagnosed celiac (GF for two years) and recently approached my
doctor about it. She wanted to give me the antibody blood tests to test for
celiac sprue. When I mentioned that one must be on a gluten-containing diet
for the tests to come out positive, she said no, one didn't. She stated that
the antibodies live in the body for years. However, she promised (and she
was very genuine) to send me some articles on this subject. So I was
wondering if anyone knew of a good medical website stating that a patient
needs to be on a gluten-containing diet in order to test positive so that I
could send her info too. I'd like to educate another doctor concerning
celiac, especially since this one seems willing to learn.
Well, here's a few suggestions I received. Special thanks goes out to Vance
and Dr. Nelson for the long emails both of them sent me. If anyone is
interested in those I'll pass them along if you ask for them. But basically
here's the summary:
www.enabling.org/ia/celiac/diag-tst.html#US
www.aafp.org/afp/980301ap/pruessn.html
http://forums.delphi.com/n/main.asp?webtag=celiac&nav=messages
and ask Chris. She has a background in this topic and is very kind and
knowledgeable.
www.celiac.com
You might try www.celiac.com/treat.html (a 27 page article on diagnosis and
treatment of celiac disease)
or www.celiac.com/frequent.html (a 23 page article of frequently asked
questions about CD)
or www.enterolab (Dr. Fine's website) for alternate testing methods.
There is an excellent, although technical article written by Joseph
Murray,MD in the American Journal of Clinical Nutrition
http://www.ajcn.org/cgi/content/full/69/3/354?maxtoshow=&HITS=10&hits=10&
RESULTFORMAT=&author1=Murray%2C+J&titleabstract=Celiac&searchid=
QID_NOT_SET&stored_search=&FIRSTINDEX=&fdate=1/1/1998
www.celiac.ca and www.gflinks.com
Article:
Branski D, Troncone R. Celiac disease: A reappraisal. J of Peds 1998;
133(2):181-187.
Catassi C, Ratsch I-M, Fabiani E, et al. Coeliac disease in the year 2000:
exploring the iceberg. Lancet 1994; 343(8891):200-203.
Van De Wal Y, Kooy Y, Van Veelen P, Vader W, Koning F, Pena S. Coeliac
disease: it takes three to tango! Gut 2000; 46(5):734-737.
(theoretical) Feighery C. Fortnightly review: Coeliac disease. BMJ
1999; 319(7204):236-239.
Accession Number
00003455-199910000-00030.
Author Fotoulaki, maria md; nousia-arvanitakis, sanda md, dch, faap;
Augoustidou-savvopoulou, persephone md; kanakoudi-tsakalides, FLORENDIA
MD; ZARAMBOUKAS, THOMAS MD; VLACHONIKOLIS, JOHN MA, DPhil Institution
From the 4th Department of Pediatrics, Aristotle University of
Thessaloniki; Biochemistry Laboratory and Immunology Laboratory, 1st
Department of Pediatrics, Aristotle University of Thessaloniki;
Department of Pathology, Aristotle University of Thessaloniki; and
Department of Biostatistics, University of Crete, Greece.
Title Clinical Application of Immunological Markers as Monitoring Tests
in Celiac Disease.[Miscellaneous Article] Source Digestive Diseases &
Sciences. 44(10):2133-2138, October 1999. Local Message
*ALL AT: UAMS, PART AT: LRVA (CHECK LRVA LIST)* Abstract The aim of this
study was to investigate anti-gliadin (IgA-AGA and IgG-AGA), endomysial
(IgA-EmA), and anti-reticulin (Ig-ARA) antibodies for monitoring celiac
disease (CD) patients while on gluten-free and gluten-containing diets.
Sera from 30 confirmed CD patients (13 boys, 17 girls), 1-24 years old,
were examined for antibodies using ELISA (AGA) and Immunofluorescence
(EmA, ARA) at 1, 3, 6, 9, and 12 months following institution of gluten-
free diet and also at 3 and 6 months after challenge with gluten. One
month following the exclusion of gluten from the diet, most antibodies
are still positive. Twenty-three to 43% of antibodies remained positive
by the end of the third month. At 6 and 9 months, 17% and 10% were
positive, respectively. At 12 months no positive antibodies were
detected. After gluten challenge, positive IgA-AGA and IgA-EmA titers
were already demonstrated at 3 months (90% and 86%, respectively), while
Ig-ARA titers showed a slow increase. Finally IgG-AGA responded with a
slow decrease of titers to gluten-free diet levels and a fast increase
upon provocation.
The morphology of the intestine at diagnosis and during the periods of
gluten-free diet and gluten challenge corresponds with the antibody
titers. On the basis of these results, immunological markers may be
applied to follow-up CD patients. IgA-AGA and IgA-EMA appear to be the
most sensitive to dietary changes in gluten and correlate best with
intestinal mucosal morphology.
Good luck!
Dawn
Los Angeles
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