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Testing Question: Is A Negative Antibody/positive Biopsy Possible?
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Hello everyone,
I just have a question because I have seen some conflicting information online. So I was wondering, is it possible to have negative antibody tests and a positive biopsy? That is of course prior to going Gluten Free, as it would certainly be possible at that point. I am just confused because I read that Antibody tests can only confirm you do not have Celiac Disease, which indicates that false negatives are not possible? But I read elsewhere and always thought that false negatives were possible? Are false negatives only possible if you've gone gluten free before testing or are false negatives also possible if you are still consuming gluten?

My doctor told me if the test came back false that it doesn't mean I don't have it, but according to this article  
http://www.uchospitals.edu/pdf/uch_007935.pdf  a negative blood test confirms that you do not have Celiac.

I am so confused. Any information to enlighten me would be a big help. Thanks!

~ Thursday

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Thank you for the reply. I will read the thread you linked me to since I am not sure which one you were saying yes to...

~ Thursday 

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Sorry... I meant yes, you can have a negative antibody test and a positive biopsy.

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Hello everyone,

I just have a question because I have seen some conflicting information online. So I was wondering, is it possible to have negative antibody tests and a positive biopsy? That is of course prior to going Gluten Free, as it would certainly be possible at that point. I am just confused because I read that Antibody tests can only confirm you do not have Celiac Disease, which indicates that false negatives are not possible? But I read elsewhere and always thought that false negatives were possible? Are false negatives only possible if you've gone gluten free before testing or are false negatives also possible if you are still consuming gluten?

My doctor told me if the test came back false that it doesn't mean I don't have it, but according to this article  

http://www.uchospitals.edu/pdf/uch_007935.pdf  a negative blood test confirms that you do not have Celiac.

I am so confused. Any information to enlighten me would be a big help. Thanks!

~ Thursday

 

 

These 2 sentences are not true. 

"A positive antibody test indicates only that a person needs a biopsy; it is not a diagnosis in and of itself."

"Biopsy of the small intestine is the only way to diagnose celiac disease."

 

 

This is extremely old school.  Doctors that insist on only giving a diagnosis via biopsy are either looking to make money off of the procedure or have liability concerns, which make them do expensive, invasive procedures to protect themselves.  If your blood work results were borderline positive, then it might be helpful to do a biopsy to confirm, however, you can also have a positive blood test and a negative biopsy.  They then tell patients they do not have Celiac so they end up getting really sick down the road because they did not go gluten free when they should have.  The small intestine has the surface area of a tennis court.....good luck finding damage if it is patchy!

 

In addition to the above scenario, you can most certainly have negative blood work and a positive biopsy. Some people are IgA deficient, which makes any blood work useless, as IgA is the antibody they are testing for.  You can have a false negative with or without consuming gluten at time of testing.  Without for obvious reasons and with because of what I just posted or you may be on medication that would interfere with testing or damage might not be enough at that point to trip the blood work. It is confusing, yes, and takes a while to learn all the nuances of testing but it is autoimmune testing and for all AI diseases, including Celiac, you can have the disease and not trip the blood work.  Symptoms play a huge role in diagnosis with these things.

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    • Thankyou both! I was wondering if my high levels left much doubt on the diagnosis. I don't see the GI until the 15th Sep and I don't think I can stand to eat gluten in that time. If he tells me to I will do so after then. After 25 years of symptoms I don't think there is much chance of healing my bowel In a couple of weeks. I'm actually terrified of the damage they might find. But I think I will need the endo since there may be other things going on with me. So great they didn't put your son through the biopsy! Once I have a formal diagnosis I have my kids to worry about also. I can't even stand the thought of my daughter having a blood test. I think she would need to be sedated as she is so fearful and pain sensitive. My son is not yet 2 so I don't think they will test him. I'm feeling so off at the moment. I think I have some anxiety and reflux going on complicating things quite a bit.
    • My son's antibodies were 300. Based on his extremely high levels, his pediatric GI suggested genetic testing instead of the biopsy. Genetic testing can't diagnose celiac on its own but combined with such high levels, the gi dr was confident a positive genetic test would confidently diagnose celiac. He warned that biopsies are small snapshots of the intestine and can miss damage. He said this is an approach used very often in Europe but not as much in the US. What sold me on that approach was the ability to put my son directly on a gluten free diet instead of waiting three weeks for the biopsy, during which time he would continue to eat gluten and feel terrible. I'm not sure if this is more common with younger patients though (our son is two), based on the idea that he's had less time to inflict damage that would show in a biopsy? We are very happy that we immediately started the gluten free diet and chose the genetic testing. Our son got the proper diagnosis and his recent number shows a drop to 71 after only 4.5 months gluten free! Not sure if this helps. Good luck and I hope you feel better soon!
    • We have been off gluten for a while now, and symptoms return when I've allowed gluten full meals… so something still isn't sitting right with me.  Checking with her doc about seeing a pediactric GI although I'm not sure how long that will take since we live in small town America. I know she didn't get at least one of the recommended full panel tests but maybe two, can someone help clarify, or is she missing two? DGP for sure and possibly EMA? And if I understand what I'm reading in other posts that the DGP can be more accurate? Thanks Her blood panel results: Ttg ab iga <.5u/ml ttg igg <.8u/ml aga ab iga <.2 u/ml aga an igg <.7u/ml iga 61mg/dL  
    • I was tested for the full panel, I believe. I had normal values for t-transglutaminase (ttg) igg,t-transglutaminase (ttg) iga, deamidated gliadin abs igg, deamidated gliadin abs iga, and immunoglobulin a qn serum.  
    • Would you review this on Find Me Gluten free?  You can  use the app or just go to it on line. If the restaurant isn't listed, there is a way to suggest it.  I have done that and it works.  Many of us look at that site/ app
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