Dr. Amy Nett: A hundred percent? Absolutely not. No. There’s very little you can say with a hundred percent certainty.
If you want to see if he’s eating gluten, what I sometimes do with my patients who are celiacs and they get sick and we want to know if it was due to an inadvertent gluten exposure, I actually just run a LabCorp comprehensive celiac panel. I think that sometimes the gluten-containing grains, I mean, first of all, he could’ve had some cross-contamination. The other thing is, I’m assuming that he did not prepare for the test in any way in terms of eating those foods as we often tell patients to do. But the other thing is like, I often see patients who have antibodies out of range for teff, and when I tell that to them they say, “What in the world is teff?” They have never heard of injera. We can’t figure out that they have eaten any teff.
So I think what we probably see is sometimes antibodies that are somewhat nonspecific and they might actually be cross-reacting in the sense that these are actually antibodies to something else more specifically, but they happen to trigger a positive response on the Cyrex Array 4. So, I would not be able to say that he’s eating gluten-containing grains in there. I don’t think this tells us whether or not he’s compliant or not.