Gluten Free diet may cure CG even with negative blood test!

collagastritis84 · Post by **collagastritis84** » Fri Jun 04, 2010 6:39 pm

I found this case study of a condition close to mine, a young man with collagenous gastritis who's blood test for celiac was negative but got better on a gluten free diet. I guess Tex was right about the blood test not being accurate! Definitely going to try a GF diet again for at least 6 months this time.

GASTROINTESTINAL SYMPTOMS OF COLLAGENOUS GASTRITIS TREATED WITH A
GLUTEN-FREE DIET. Janice Heikenen1, C. J. Cold2, J. M. Resnick2, 1Pediatrics/Gastroenterology, Marshfield
Clinic, Marshfield, WI; 2Pathology, Marshfield Clinic, Marshfield, WI
A previously healthy 13 year old boy presented with a 6 month history of generalized abdominal pain, frequent
loose nonbloody stools and a 2.5 kg weight loss. Evaluation was unremarkable with a normal CBC, metabolic panel, Helicobacter pylori antibodies, TSH, inflammatory markers and endomysial and tissue transglutaminase antibodies. He was an HLADQ8/HLADQ2 heterozygote with a family history of "gluten intolerance". Stools were negative for pathogens and occult blood. An abdominal CT was negative. An EGD was abnormal with diffuse nodularity of the gastric body and fundus with antral sparing. Biopsies from the gastric body showed a chronic active gastritis with surface epithelial injury and a markedly thickened, structurally abnormal subepithelial collagen table consistent with collagenous gastritis (CG). The antrum was notable only for mild chronic gastritis with an unaltered subepithelial collagen table and negative Helicobacter pylori immunostain. Biopsies and disaccharidases from the duodenum were normal. Colonoscopy was visually and histologically normal. A gluten-free diet (GFD) resulted in symptom abatement at one month with resolution by 6 weeks. Sustained symptom resolution one year following diagnosis is reported. Repeat endoscopy 6 months following treatment showed only patchy subepithelial collagen table thickening. CG is an uncommon pediatric diagnosis. Clinical symptoms and endoscopic findings are variable with
the diagnosis based on standard histologic criteria from a gastric mucosal biopsy specimen. The etiology,
pathogenesis and natural history of CG remain unclear. A variety of therapeutic interventions have been attempted without consistent symptomatic or pathologic improvement. In our patient, a GFD appeared to be an effective treatment for the management of gastrointestinal symptoms. Although the precise pathogenic mechanism of CG is
unknown, intraluminal gluten may be involved in the pathogenesis and/or symptoms of CG. Treatment with a GFD is a viable treatment option for pediatric patients with collagenous gastritis.
44 GASTRIC ANTRAL VASCULAR ECTASIA (GAVE). Brent Keith,

Post by **tex** » Fri Jun 04, 2010 9:05 pm

Good work, finding that case study report.

Thanks for posting this.

Tex

Gloria · Post by **Gloria** » Fri Jun 04, 2010 9:13 pm

He was an HLADQ8/HLADQ2

Aren't both these genes celiac genes? I thought the medical community at least recognized the genetic markers for celiac disease.

Gloria

Post by **tex** » Fri Jun 04, 2010 9:26 pm

Yes, the report even mentions that he was a heterozygote, meaning that he had one of each of the two common celiac genes, but that means nothing to a celiac specialist, unless the patient shows a positive response to a celiac blood test.

(A homozyhgote has two identical copies of a gene, such as HLADQ2/HLADQ2).

Tex

collagastritis84 · Post by **collagastritis84** » Fri Jun 04, 2010 9:38 pm

Would you recommend me getting the gene test? Is it flawed like the antigen test?

Stanz · Post by **Stanz** » Fri Jun 04, 2010 11:03 pm

The blood test only will identify the main celiac genes, it will not identify gluten sensitive genes. 1 in 100 people are celiac, 1 in 4 people are estimated to be GS via the gene test.

I am frankly stunned that this study came out of the US, imagine it's been pretty well buried.

Post by **tex** » Sat Jun 05, 2010 8:53 am

The gene test will show which genes you have, which will define your "potential" for developing gluten-sensitivity, or celiac disease, but it will not tell you whether or not you actually have celiac disease, nor whether or not you are actually gluten-sensitive. Before disease can develop, those genes have to actually be triggered by some external "traumatic" event.

Connie,

The study is buried. I can't find where it was actually published in a medical journal, (on the web), however, it shows up in the proceedings of the NASPGHAN - CDHNF Clinical and Scientific Conference in 2008, November 13 – 15, 2008. It probably was published in some medical journal, but I can seem to locate it.

http://www.naspghan.org/user-assets/Doc ... 0FINAL.pdf

Tex