What Causes Elevated Deamidated Gliadin IgG Levels In Children?

Posted on Sat, 17 Oct 2015

Question: Hi Dr Narasi - my 4 yeare old little boy had a result of 35 on his deamidated gliadin IgG coeliac serology in January this year - it has just been retested and has increased to 152 - all the other results remained <1. his endoscopy in XXXXXXX showed he wasn't celiac but had bad reflux which he was put onto somac - he is not on gluten restricted diet - any ideas as to why its increased - or could it mean he has become celiac - aside from ferritin being low his Vit b12 is high and folate are fine - any ideas

Answered by Dr. Dr. Pradeep Kumar Jain (20 hours later)

Brief Answer:
He may develop celiac disease in future

Detailed Answer:
Hello

Thanks for asking on this platform

I completely understand your concern.
The deamidated gliadin IgG(IgG AntiDGP) is a very sensitive marker for detection of celiac disease and it's value rises much before the detection of other antibodies and even before the actual detection of celiac changes in intestinal biopsy.

The investigations for celiac disease are usually advised when there are symptoms suggestive of celiac.I would like to know if there were any other symptoms(like irregular bowel,poor growth) apart from the iron deficiency.

I have gone through the details and I have concluded that your child was in very early stage of celiac disease(anti DGP of 35 with normal intestinal biopsy).
Now the rising level of AntiDGP(with other results <1)indicates that the disease is growing inside.
I would like to know if there is any improvement(in lab values and clinical condition) after introduction in iron therapy.The iron deficiency may persist even after treatment in celiac disease due to poor absorption.
Please get back with the answer of my questions.

If symptoms are persistent or have worsened,I would like to get a repeat biopsy test done.But if there are no specific complaints,I would suggest you to follow him up with serial serological tests at frequent intervals or let the symptoms to appear.

I hope this helps.
Please let me know if you have any more query.
Wishing for your child's good health.
Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar