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Hello,

I recently had a scope to determine reasons for weight loss, fatigue, bloating, and dry itchy skin and psorasis. I obtained the lab results today but am unable to meet with the doctor until after the holidays. Could someone please help me interpret the results.

Biopsises of duodenum

-marked increase in intraepithelial lymphocytes

Comment: Sections from duodenum show marked increase in intraephithelial lymphocytes and expansion of lamina propria by mononuclear inflammatory infiltrate. Focal minimal activity and crypt abscess is also noted. Villous blunting is noted in well oriented duodenal villi. Clinical and serological correclation is recommeded to rule out Celia disease. H. pylor micro-organisms are nto identifed on routine stains in sections examined.

Biposies of gastric antrum:

-gastric antrum and body type mucosa with mild chronic gastritis

-negative for intestinal metaplasia, dysplasis or malignancy

-negative for H. pylori micro-organisms on routine and special stains

I also have vitilogo. It was my understanding that biopsy would be the determining factor for a diagnosis of Celiac, so am confused about the recommendation for bloodwork.

Thanks in advance.

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Hello,

I recently had a scope to determine reasons for weight loss, fatigue, bloating, and dry itchy skin and psorasis. I obtained the lab results today but am unable to meet with the doctor until after the holidays. Could someone please help me interpret the results.

Biopsises of duodenum

-marked increase in intraepithelial lymphocytes

Comment: Sections from duodenum show marked increase in intraephithelial lymphocytes and expansion of lamina propria by mononuclear inflammatory infiltrate. Focal minimal activity and crypt abscess is also noted. Villous blunting is noted in well oriented duodenal villi. Clinical and serological correclation is recommeded to rule out Celia disease. H. pylor micro-organisms are nto identifed on routine stains in sections examined.

Biposies of gastric antrum:

-gastric antrum and body type mucosa with mild chronic gastritis

-negative for intestinal metaplasia, dysplasis or malignancy

-negative for H. pylori micro-organisms on routine and special stains

I also have vitilogo. It was my understanding that biopsy would be the determining factor for a diagnosis of Celiac, so am confused about the recommendation for bloodwork.

Thanks in advance.

Yes, the biopsy has always been considered the 'gold standard' of celiac diagnosis, but it sounds like you are in the early stages and the pathologist who read your slides was not totally convinced. Everything I have bolded is indicative of celiac disease. He is suggesting that your doctor run the celiac blood panel for confirmation of celiac.

For now, you can enjoy the holiday food as much as you can because these might be your last glutenous holidays :D

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Yes, the biopsy has always been considered the 'gold standard' of celiac diagnosis, but it sounds like you are in the early stages and the pathologist who read your slides was not totally convinced. Everything I have bolded is indicative of celiac disease. He is suggesting that your doctor run the celiac blood panel for confirmation of celiac.

For now, you can enjoy the holiday food as much as you can because these might be your last glutenous holidays :D

Thank you very much for your response.

My doctor has been trying to find the source of the fatigue, weight loss, etc (along with a B12 deficiency and anemia), so while I am not thrilled about the possible celiac diagnosis, I understand that there are far worse alternatives. Lymphoma has been ruled out after I had a CT scan that was negative after enlarged lymph nodes were detected on MRI.

I will enjoy the festive holiday treats and have the blood tests in the new year!

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Good luck with your blood tests; I hope you get clear results. :)

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Hello again,

Firstly, I would like to thank everyone who has ever written a post on this site. I feel like I have read them all and am astounded by the depth and breadth of knowledge!

I had a follow up visit today with my doctor. Blood test (ttg IgA) results confirm diagnosis of Celiac Disease, following biopsy. Lab result was >80 with <4 being the reference range.

Additional blood tests showed elevated Red Blood cells (17.3 with reference range 11-14.5), elevated ESR (20 with reference range 0-12), Low RBC folate (319 with reference range of >829, and low ferritin (10 with reference range of 11-145).

I currently take B12 shots every three weeks. He has suggested 5 mg of folic acid. He didn't check my iron, so I am going tomorrow to have that blood test performed. Other then the folic acid, is there anything else he should be recommending. He self admitted that he does not know much about Celiac Disease and has referred me to a GI.

I have now been on a gluten free diet for 5 weeks. I am encouraged that I am seeing some small improvements..... less gastrointestinal issues, more restful sleep, gained 4 pounds :)

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Hey learningabouceliac!

Thanks for thinking to post an update. I'm so glad to hear you have a definitive answer, and it sounds like you are on your way to healing!

Cheers!

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    • Hi Lisa, I completely understand why you didn't do a biopsy on your daughter.  I went through the appendix thing myself...not fun!  I was diagnosed with just bloodwork and no biopsy, but did have the full panel.  I would go back to your PCP and ask for a full panel to include TTG, EMA and DGP tests.  Since she was already willing to test you, I'm sure she would be willing to order these.  Good luck!
    • What a gross title–it bothers me and I wrote it! It wasn't my idea originally. The research paper the data came from was entitled, "Experimental hookworm infection and gluten microchallenge promote tolerance in celiac disease" published recently in the Journal of Allergy and Clinical Immunology. View the full article
    • katesyl.........this is an older topic so the OP most likely won't answer.  I can, however, offer a piece of advice for you. Just going gluten free will probably not drive your inflammation markers down into normal.  It does depend on how high they were to begin with but with all autoimmune diseases, there will be inflammation going on forever.  Get used to wonky blood work because most of us will have that issue. I have 4 autoimmune diseases in total and, although I have driven certain inflammatory markers way down, my recent sed rate number was elevated.  The normal is supposed to be 30 and under in a woman my age but mine is 50.  With 4 AI diseases, I doubt it will ever be normal and I don't let it bother me. I am not willing to take major meds at all and use more natural anti-inflammatory supplements.  You can do whatever you feel comfortable with in regards to treatment but don't expect normal numbers with Celiac Disease. Inflammation will improve but normal?  Most people never get there completely.
    • My daughter's PCP did not go against anything, she offered to do the biopsy - I was the one opposed to it. My DD, who was 10 at the time had just spent 3 weeks in the hospital, very sick with a ruptured appendix, then had 2 surgeries a few months after. I didn't see the need to put her through anything else with her numbers so high and all the classic symptoms. Apparently, in some other countries, if your numbers are all high, they forego biopsy. Anyway, I was really asking about myself and whether I should push for add'l testing. I am still new this this and trying to get up-to-date and wasn't sure if my PCP should conduct other blood tests before I go completely gluten-free. I have been somewhat gluten-free, but not entirely. I have no problem going gluten-free, but want to make sure that I am doing it for the right reasons. I wasn't sure if the Gliadin Abs IgA was sufficient to point to Celiac and possibly doing a biopsy for me. Or if additional blood test would make more sense.   Thanks!!
    • I would like to know if you have found out the source of your inflammation yet. I'm gluten free three years but my inflammation test was high.
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