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Do You Have Pos Blood & Neg Biopsy?


GEF

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GEF Explorer

... and I'm assuming they expect you to throw the blood tests in the trash...

Gretchen

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A normal small bowel biopsy rules out celiac sprue, a true malabsorption state in which intestinal cells are visibly damaged, but it does not rule out gluten sensitivity. Although asymptomatic people with gluten sensitivity may have normal or near-normal biopsies, so also may people with symptomatic gluten sensitivity. This has been reported in the medical literature called "Gluten Sensitivity with minimal Enteropathy" or "Gluten-Sensitive Diarrhea without Celiac Disease". Even though such people's intestines appear normal under the microscope, up to one half already have nutrient malabsorption, a major contributor to osteoporosis and malnutrition, leading to the conclusion that microscopic analysis of intestinal biopsies is an insensitive way of assessing immunologic food sensitivity. However, because there is still a virtually universal reliance on small bowel biopsies to diagnose gluten intolerance, most asymptomatic or symptomatic gluten sensitive people are told they do not have a diagnosis of celiac sprue, and are given no recommendations to modify their diets.


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gf4life Enthusiast

Gretchen,

That is a great article, thanks for putting it here. It is exactly this reason why I like Dr. Fine's Enterolab tests. They pick up gluten sensitivity, where it is usually missed in the Celiac bloodtests and biopsy, yet still needs a gluten-free diet for optimum health.

Dwight Senne Rookie

Hmmmmm, that is a very interesting article. Seems to offer an explanation for all these negative biopsy results. He raises a good point in that even after a negative biopsy, it may be worthwhile to go on the diet to see if symptoms improve.

CarolynM Newbie

This is exactly where my daughter is right now! Positive antigliadin, negative biopsy but consistent symptoms that I tracked along with her diet and found the connection to wheat! That is why they did the blood tests; I almost feel like the doctor doesn't acknowledge the possibility that she is still at the least gluten-sensitive because it wasn't his "idea". He never mentioned there could be anything "in-between" - he basically told me either you have celiac disease or wheat is the greatest thing on earth for you. We got results from the biopsy a month ago; I wanted to believe the results but still see the correlation with wheat in her diet. We have just returned from a fun but messy and stinky vacation and are going gluten-free tomorrow - wish us luck! She is nearly 3 and loves wheat products.

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    • trents
      So the tTG-IGA at 28 is positive for celiac disease. There are some other medical conditions that can cause elevated tTG-IGA but this is unlikely. There are some people for whom the dairy protein casein can cause this but by far the most likely cause is celiac disease. Especially when your small bowel lining is "scalloped". Your Serum IGA 01 (aka, "total IGA") at 245 mg/dl is within normal range, indicating you are not IGA deficient. But I also think it would be wise to take your doctor's advice about the sucraid diet and avoiding dairy . . . at least until you experience healing and your gut has had a chance to heal, which can take around two years. After that, you can experiment with adding dairy back in and monitor symptoms. By the way, if you want the protein afforded by dairy but need to avoid casein, you can do so with whey protein powder. Whey is the other major protein in dairy.
    • jenniber
      hi, i want to say thank you to you and @trents   . after 2 phone calls to my GI, her office called me back to tell me that a blood test was “unnecessary” and that we should “follow the gold standard” and since my biopsy did not indicate celiac, to follow the no dairy and sucraid diet. i luckily have expendable income and made an appt for the labcorp blood test that day. i just got my results back and it indicates celiac disease i think 😭   im honestly happy bc now i KNOW and i can go gluten free. and i am SO MAD at this doctor for dismissing me for a simple blood test that wouldn’t have cost her anything !!!!!!!!!!! im sorry, im so emotional right now, i have been sick my whole life and never knew why, i feel so much better already   my results from labcorp:   Celiac Ab tTG TIgA w/Rflx Test Current Result and Flag Previous Result and Date Units Reference Interval t-Transglutaminase (tTG) IgA 01 28 High U/mL 0-3 Negative 0 - 3 Weak Positive 4 - 10 Positive >10 Tissue Transglutaminase (tTG) has been identified as the endomysial antigen. Studies have demonstrated that endomysial IgA antibodies have over 99% specificity for gluten sensitive enteropathy. Immunoglobulin A, Qn, Serum 01 245 mg/dL 87-352
    • JoJo0611
      Thank you this really helped. 
    • Samanthaeileen1
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    • GlorietaKaro
      One doctor suggested it, but then seemed irritated when I asked follow-up questions. Oh well—
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