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From:
Albert D. Biderman <[log in to unmask]>
Date:
Thu, 7 Sep 2000 00:29:28 -0400
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<<Disclaimer: Verify this information before applying it to your situation.>>

This is a belated summary of replies to a post in which I asked whether
anyone knew of a checklist of tests recommended for monitoring diagnosed
Celiacs.   I desired a list attributable to an authoritative source that
my primary care physician might accept as valid.  Her panel includes
only one other diagnosed CD patient and I can't expect her to stay fully
conversant with the CD literature.  Because CD isn't my only (or worst)
problem, I'd rather have my internist than a specialist have primary
responsibility for monitoring my health.  If I find there are tests she
has not ordered or that she does not order as often as experts suggest,
I want to be able to call that to her attention.

Since I posted the item, several other list members have expressed a
desire for such a checklist.

I quoted in my message a summary by one member, Kim Goodman, of
responses to an inquiry she posted about "future tests for a newly
diagnosed Celiac."  Her summary fell short of my purpose in that it did
not not identify sources.  She reported receiving multiple suggestions
for the following tests:

> Bone Density, T3, T4 and TSH Levels (thyroid), blood work panel on digestive
> enzymes, liver enzymes, and iron; nutrient levels, hemocult, calcium, vit D,
> iron, folate, [folic acid], vit K, vit B12, magnesium, and zinc levels.

Replies to my post my suggested adding to the above:

  "blood tests, CBC, Chem screen, Glucose, electrolytes, 24-hour urine
test for protein,  comprehensive  physical examinations, at least one
follow-up biopsy"

The suggestions I received did not lead me to any listing that had all
the properties I sought.  The closest I found was the section on
"Follow-Up Care" in the summary of a 1996 presentation at the
Westchester Celiac Sprue Support Group by  Peter Green, M.D.,
Gastroenterologist and Director of the GI Endoscopy Unit,
Columbia-Presbyterian Medical Center, NYC, titled "Initial Assessment
and Follow-up Care of Celiac Patients."  It is available at:

     <http://www.enabling.org/ia/celiac/doc/medcare.rtf>

Although Dr. Green's suggestions of tests occur in a discursive
discussion of care rather than in checklist form, the section is quite
succinct.

Three people referred me to writings of Dr. Joseph A. Murray but I did
not locate any with the kind of compiled listing I sought.

I have not included here suggestions I received about follow-up care
other than for monitoring.

Given the broad range of conditions known or suspected to be associated
with CD, I assume that  the scope of any universally applicable list
would necessarily be limited to checks for directly and frequently
linked conditions..

--- Albert D. Biderman
--- [log in to unmask]

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