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Blood Tests


NYCisTHEplaceTObe

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NYCisTHEplaceTObe Rookie

I was wondering about the accuracy of the IGG test. Apparently that is the only celiac related test that my doctor did, which I was not happy about. We haven't gotten any results back on anything yet. I have another appt coming up and this time I am demanding that I get the full panel done. I don't understand why it is so hard for doctors to listen to their patients!


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KaitiUSA Enthusiast

The IgG is the least accurate test of them all. The tTG is the most accurate test.

The full panel should be done which includes: IgG, IgA, total serum IgA, EMA, tTG

BabySnooks Rookie
The IgG is the least accurate test of them all. The tTG is the most accurate test.

The full panel should be done which includes: IgG, IgA, total serum IgA, EMA, tTG

<{POST_SNAPBACK}>

Dear Kaiti,

I had an Endoscopy/Colonoscopy in July. The doctor (whom I am very happy with) said the small bowel biopsies showed flattening of the villi and increased inflammatory cells suggestive of celiac sprue. Antibody blood tests revealed 2 of the antibody tests were in the normal range and 2 were in the elevated range. He suggested I go gluten-free and go back to him, which I did in October. Shortly before my appointment with him, I discovered that the calcium tablets I have been taking contained gluten! Instead of taking another blood test, he suggested I do a gluten challenge, which I am now doing. I am feeling fine, as I did before the tests. After 3 months, I will return to the doctor for more blood tests and eventually a repeat endoscopy and colonoscopy. (As an aside, he found a polyp in July that had to be removed by a surgeon and it was stage I cancer. Luckily I didn't have to go through chemo.) Another side note is that he found a small area suggestive of colitis during the colonoscopy. All of this from a "routine" colonoscopy!

My doctor said that the 2 antibody tests that are the most accurate were normal in my case. Also, the 2 antibody tests that are the most inaccurate were elevated in my case. What I am wondering is: If I return to the doctor after my gluten challenge and the antibody tests are all normal, and a repeat biopsy still reveals inflammatory cells and flattened villi, where does that leave me? Isn't the wheat/gluten issue the only thing that would cause flattened villi?

I'm not asking for a medical opinion here, just if you or anyone else here has experienced this type of situation.

Meanwhile, I am enjoying my morning mini-wheats and toast and a host of other wonderful wheat products. I am not getting my hopes up--just enjoying a 3-month vacation from gluten-free!!

Thanks for listening. :)

Sharon

Carriefaith Enthusiast

Sharon, based on those results, a positive biopsy and 2 positive blood tests, I would say that you have celiac disease and I am confused as to why the doctor is trying to prove it :unsure: There are other things that can cause flatening of the villi; however, if you have positive celiac bloodwork, then my guess is that you have celiac. Did you feel better on the gluten-free diet? Feeling better on the gluten-free diet is also a positive test.

BabySnooks Rookie
Sharon, based on those results, a positive biopsy and 2 positive blood tests, I would say that you have celiac disease and I am confused as to why the doctor is trying to prove it  :unsure: There are other things that can cause flatening of the villi; however, if you have positive celiac bloodwork, then my guess is that you have celiac. Did you feel better on the gluten-free diet? Feeling better on the gluten-free diet is also a positive test.

<{POST_SNAPBACK}>

Hi Kaiti,

I felt exactly the same on the gluten-free diet as I did before and as I feel now--fine! That's why I have to rely on the results of tests. I have no symptoms. For those of you who unfortunately get very ill after ingesting gluten, you go gluten-free and feel better, case closed. I think my doctor just wants to be sure.

Thanks for your opinion.

Sharon

Rachel--24 Collaborator

I have to agree with Carrie on this one. You clearly have celiac disease...a positive biopsy and positive bloodwork = celiac disease. I'm also confused as to why your doctor would want to have you go gluten-free, then do a challenge, and then redo the tests. To me the tests were not inconclusive the first time. :unsure:

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    • trents
      NCGS does not cause damage to the small bowel villi so, if indeed you were not skimping on gluten when you had the antibody blood testing done, it is likely you have celiac disease.
    • Scott Adams
      I will assume you did the gluten challenge properly and were eating a lot of gluten daily for 6-8 weeks before your test, but if not, that could be the issue. You can still have celiac disease with negative blood test results, although it's not as common:  Clinical and genetic profile of patients with seronegative coeliac disease: the natural history and response to gluten-free diet: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5606118/  Seronegative Celiac Disease - A Challenging Case: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9441776/  Enteropathies with villous atrophy but negative coeliac serology in adults: current issues: https://pubmed.ncbi.nlm.nih.gov/34764141/  Approximately 10x more people have non-celiac gluten sensitivity than have celiac disease, but there isn’t yet a test for NCGS. If your symptoms go away on a gluten-free diet it would likely signal NCGS.
    • Xravith
      I'm very confused... My blood test came out negative, I checked all antibodies. I suppose my Total IgA levels are normal (132 mg/dl), so the test should be reliable. Still, I'm not relieved as I can't tolerate even a single biscuit. I need to talk to my doctor about whether a duodenal biopsy is necessary. But it is really possible to have intestinal damage despite having a seronegative results? I have really strong symptoms, and I don't want to keep skipping university lectures or being bedridden at home.
    • Scott Adams
      They may want to also eliminate other possible causes for your symptoms/issues and are doing additional tests.  Here is info about blood tests for celiac disease--if positive an endoscopy where biopsies of your intestinal villi are taken to confirm is the typical follow up.    
    • Scott Adams
      In the Europe the new protocol for making a celiac disease diagnosis in children is if their tTg-IgA (tissue transglutaminase IgA) levels are 10 times or above the positive level for celiac disease--and you are above that level. According to the latest research, if the blood test results are at certain high levels that range between 5-10 times the reference range for a positive celiac disease diagnosis, it may not be necessary to confirm the results using an endoscopy/biopsy: Blood Test Alone Can Diagnose Celiac Disease in Most Children and Adults TGA-IgA at or Above Five Times Normal Limit in Kids Indicates Celiac Disease in Nearly All Cases No More Biopsies to Diagnose Celiac Disease in Children! May I ask why you've had so many past tTg-IgA tests done, and many of them seem to have been done 3 times during short time intervals?    
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