Testing Question: Is A Negative Antibody/positive Biopsy Possible?

[Thursdaysangel77]

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  
Open Original Shared Link  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

[NoGlutenCooties]

In a word... yes. 

We had a discussion about this not too long ago: https://www.celiac.com/forums/topic/105385-how-accurate-are-the-tests/

That thread has some good links that may help.

 

Welcome to the Forum!

[Thursdaysangel77]

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 

[NoGlutenCooties]

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

[Gemini]

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  

Open Original Shared Link  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.