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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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    • I had a negative biopsy and was still diagnosed with Celiac. My GI ran a bunch of tests looking for the cause of my 15+ years of diarrhea and the only thing that came back positive was the entire Celiac panel. All very high. So he performed an endoscopy with biopsy. The biopsy was negative. So he ordered a genetic test. When that came back as "high risk" he decided a trial gluten free diet was in order. After 8 weeks my symptoms resolved and my antibodies were back to normal. Since then, follow up testing had shown I have osteoporosis. I am a 40 year old male.  So yes, you can definitely still have it and have significant damage with a negative biopsy. 
    • Annual celiac antibody testing is, in my opinion (and based on what celiac researchers have published), is critical, especially for a 12 year old.  Life is going to get harder for her.  Peer pressure is huge (I have a 15 year old daughter), and remaining diet compliant can be tough.   In Dr. Fasano's, Gluten Freedom, he discusses a young patient who became ill in high school after being gluten free for years.  His parents were perplexed.  Dr. Fasano took the young man aside and he confessed that while on a date, he didn't want to bring up his celiac disease.  So, he ate pizza.  He was too embarrassed to tell his parents.   My daughter does not have celiac disease.  She was first tested two years ago.  Since she is symptom free, is not anemic and her other lab work is fine, we'll wait to test her in another year.  It all depends on the patient, but every few years, testing is recommended for all undiagnosed first-degree relatives.   It certainly sounds like your younger children should be screened.   I wish you both well!      
    • Perhaps you should consider asking for a GI referral.  You might just skip the blood tests and go directly to an endoscopy/biopsies while you are still consuming gluten.  It is the "gold" standard for a celiac diagnosis anyway!   Here's the deal with going gluten free.  You can do it.  It costs nothing, but you must give it six months or longer.  You'd need to think like a celiac, but it can be done!  I'll tell you my tale.  My hubby went gluten-free 15 years ago per the very poor advice of his GP/PCP and my allergist.  After a year of mistakes and learning, he got well.  It worked!  Thirteen years later, I was formally diagnosed.  (It was a shock as I was only anemic at the time.)  Hubby would be the first to say that I have had way more support from family, friends and medical.  I must say, it's nice to see those lab results.  It really helped me adhere to the diet in the beginning too.   So, you know your medical situation.  You must do what's best for you!   I hope you feel better soon!  
    • I'm sure going to have a long talk with my doctor.  Then I'll find a new one that will support me and make sure that my daughter and I both have the proper testing done yearly.  
    • also:  glutendude - i don't get it.  shouldn't it be glutenfreedude?  lolz i eat out few and far between.  most of the times i've been glutened it's been eating out.  this weekend i'm getting my bacon cheeseburger on at red robin  i always get my 'good' waitress - lucky, i guess, paula takes good care of me   and i will eat at bonefish but they have a limited 'safe' menu.  look for places that have the 'GiG'  training they know their stuff.  mellow mushroom, melting pot, california pizza kitchen, pf changs are all supposed to be trained that way.  they know to avoid cc and change their gloves, etc.  
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