Gastroenterology results: need help interpreting please

[Cherylclaire]

Got sent a large amount of final Gastroenterology results, and there are some things on it that I need help with, if anyone can read through it, I'd be grateful:

Just putting relevant bits in since it's 12 pages long.

Potassium level: 5.1 (3.5- 5.0 mmol/L)

Sodium level : 146 (range 135-145 mmol/L)

(These above are not drastic, and could be due to multivitamins and minerals tablets)

Alanine Trans Level: 85 (4- 59 IU/L)

GGT: 81 (4- 60 IU/L)

ESR: 15 (0-19 mm/hr) - only put this in because it used to be 5 - 7... improvement I think ?

The suspected flattened mucosal pattern in duodenum - possible Coeliac indicator? - was, on biopsies, "normal" and Coeliac tested for and ruled out but "patchy gastric metaplasia" noted....... ?

Holo TC (active B12) >128 (25-108 pmol/L) -as expected when SI every other day

Intrinsic Factor Antibodies: negative

Gastric Parietal Cell Ab.: negative

Methylmalonate = <3 umol/mmol Cr (ref range <10)

Methionine level 14 (10 - 53 umol/L)

Ferritin still lowish despite supplements: 36 ug/L but Folate over 20 ug/L, which is good or possibly too good ? Not sure.

Any help will be really useful. Most of the rest of it looked fine, far as I know.

[fbirder]

Your ALT (alanine transaminase) is ‘mildly elevated’. Mine has been higher than that when I’ve had a pub session the night before. The same can cause elevated GGT. However, I would imagine the doc would like to investigate further, maybe repeating the test.

‘Patchy gastric metaplasia’ is what you’d expect from somebody with PA (which is caused by autoimmune metaplastic gastric atrophy) but you don’t have the GPC antibodies that would be expected. Ask the gastroenterologist on your follow up if AMGA is a possibility.

[Cherylclaire Forum Support in reply to fbirder]

Thanks, fbirder, but there is no follow-up. She told me that, as far as her department was concerned, I had IBS, although admitted that this did not explain any of my other symptoms.

Would anything else that you know about cause "patchy gastric metaplasia" ?

I still, after over 3 years, have had no reason given for B12 deficiency/ functional B12 deficiency. Since I have been self-injecting every other day for a year now, I would really like "being a vegetarian" ruled out as the cause. Still trying for improvements rather than just attempting to keep symptoms at bay.

[fbirder in reply to Cherylclaire]

I would write asking what caused the metaplasia.

As far as I can tell (and I've not looked into it a lot) it's either autoimmune or environmental. Environmental causes include H. pylori infection and the usual suspects (smoking, alcohol and we don't know).

[Cherylclaire Forum Support in reply to fbirder]

Thanks, fbirder - I hand-delivered a letter to her in June, asking 5 questions. She sent me this 12-page list of test results without any letter or answers to those questions 4 months later, so I think that well has dried up. Back to GP is probably my best bet now.

I have not forgotten that in about May next year, the Inherited Metabolics Diseases consultant will be arranging a final appointment to discuss DNA findings. Will let you know, because I have a feeling that this is an area that would interest you.

Meanwhile I'm just going to carry on self-injecting every other day in order to function.

[fbirder in reply to Cherylclaire]

Yes, that does sound interesting.