Confused About Whether Or Not To Get Biopsy

[rach7]

I have had some health issues and my husband suspected Celiac. I asked my doctor about it and he ran the blood tests. I had already gone gluten free 2 weeks prior, but he said that I should still have it in my system. I received a call from his office and they said that one of my tests was positive. I asked which one and they said the iga. They said normal is 1-19 and mine is a 25. They said to go on a gluten free diet, but said nothing about getting the biopsy. It is my understanding that if you test positive on the blood test, then you're supposed to get the biopsy. I don't know what to do. Can anyone help?

[SMRI]

The blood tests are very accurate. It was once thought that you had to have a biopsy to confirm but not really any longer.  Many dr's still do them though.  It is really up to you but with a positive blood test, you have Celiac.  Some people like to do the biopsy so they have a baseline to see what damage is there and how they heal over time, but isn't not necessary.

[nvsmom]

Not all doctors insist on the biopsy if you've had positive blood tests; although most still do.  The biopsy is not a perfect test though, it can miss up to 1 in 5 celiacs, but for those who doubt their diagnosis it can be helpful.

 

I am guessing that your positive test was the tTG IgA (anti-tissue transglutaminase immunoglobulin A).  It is the most common test given. It's celiac specificity if around 95%, which means that 95% of all positives are caused by celiac disease.  The other 5% are usually caused by thyroiditis, diabetes (type 1), crohn's, colitis, chronic liver disease, or a serious infection; if none of those problems apply to you, then you are probably one of the majority whose positive test was caused by celiac disease.

 

The other celiac tests are:

• tTG IgG (and tTG IgA)
• DGP IgA and DGP IgG
• EMA IgA
• total serum IgA - a control test to make sure you make enough IgA for accurate IgA based celiac tests (about 5% of celiacs are IgA deficient and will have false negative IgA based celiac tests)
• AGA IgA and AGA IgG - these tests are similar to the DGP tests but not as accurate or as reliable.

You might want to consider getting the other tests done if you doubt your diagnosis.  You need to resume eating gluten for a few weeks prior to testing though.... It probably is a good idea to find out what test was run though.  The (total serum) IgA is not a celiac test, but it usually has a range into the hundreds (based on your age) so I don't think that is what they were referring to.

 

Welcome to the board!  

[Solandra]

I was mildly high on the AGA IGA test, 22 and normal is under 19, but the TTG tests were at 4 and 5, and anything under 19 is normal. Since I have an autoimmune disease, my Endo said that can affect the results. This was a little over two years ago. I went gluten free and didn't notice a difference, so I'm adding it back in and rerunning the blood tests and then if that's positive on more than one I might do the biopsy. For me, being gluten free is a pain in the ass, and my husband thought it was pointless and just a fad diet and always gave me crap about it. It's also very expensive and kind of triggers anxiety and OCD for me with trying to eat perfectly. I'd like to be as certain as possible before I commit to this for the rest of my life.