a girl child with h / o wheat allergy is now taking wheat without any problems but her ttg test is still positive. my question is whether one should stop her wheat diet.on other diet plans she start losing wt and appetite and her parents give her wheat again .she gains wt and has no other symptoms whatsoever while on wheat

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If she has wheat (gluten) allergy, she should not take wheat again, it will damage her intestines further and put he at risk for auto immune diseases. She can take gluten free grains like rice, ragi, nachni, bajra, rajgira.

agreed with dr Anukalp. No point in prescribing gluten free diet to this child. if biopsy is nornal, then you should look for other causes of iron deficiency anemia most notably worms or thalassemia trait.

thanks dr lily and dr karthiak for your valuable time and suggestions. I will definitely work up on case and let you know.problem is she has no interest in other grains. As her parents told me that they have not stopped gluten diet for 2 yrs and she is doing well . they don't understand the pathological changes going on in intestine. how to advice them is a big practical question

She is having microcytic hypochromic anaemia with slightly elevated RDW. Kindly evaluate her for iron deficiency anaemia and hemoglobin HPLC for underlying hemoglobinopathy..

The child doesn't know what's good for her. Just like children don't know need for school. It's up to the parents. And once it becomes a habit she won't miss wheat any more. The parents are just using this as an excuse to make their work easy.

you can council them that this anaemia is a result of the malabsorption she is suffering from. if she want to live healthy she has to stick to the limitations of food.

in my gp if I go for vit d test to any pt it's always very low .is this test of any significance as pts are not having any symptoms related to it and it's costly too or we can supplement vit d empirically .I tried it on symptomatic and non symptomatic pts.redults is always the same

I would respectfully disagree, gluten is causing ' leaky gut' which is responsible for her symptoms. Definitely she needs to go gluten free. Irrespective of biopsy result.

I think it will be very useful to check out articles by Dr David Perlmutter, and read his book, Grain Brain. It will bring a lot of clarity to this issue.

if TTG is positive n D2 biopay was normal tgen she is a case of Potential celiac disease....these patients have high chances of developing celiac disease in future....there isn't any recommendation to put these patients on GFD....

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