Biopsy Results - Help Appreciated

[sunblazed]

Hi All,

 

I had my biospy taken last week, fortunately my girlfriend works at the hospital and was able to send me the lab results. I have my follow up tomorrow with the consultant.

 

Firstly I've had a full blood panel done. ttg Iga - 83, iGA-as, gliadine - all came back 'strongly positive'

The lab report states that the duodonel tissue shows atrophic mucosa with small increase in intra epithelial lymphocytes.

What I found weird is no mention to the Villi. Is this odd? I'm curious where I fall on the 'marsh diagnostics' - from what I read it could be stage one, but considering their is no mentio of villi at all I'm a bit confused. PResumably safe to say I am Celiac?!

 

Thanks in advance for any comments!

[nvsmom]

It looks like it was a marsh  1 or maybe 2.  These are often thought to be early celiac disease.  It is possible that you still in the early stages of celiac disease or that the doctors failed to biopsy the more damaged areas.  

 

Your biopsy doesn't fully support the celiac disease diagnosis but it doesn't disprove it either.  You still have two strongly positive tests that are pretty specific to celiac disease, especially the tTG IgA.  You could have had a negative biopsy and still have serologically positive celiac disease.  It isn't too unusual. I'd say it's most likely celiac disease...On the bright side you cab start eating gluten-free and you'll probably be feeling better in a few months.  

 

I found this Marsh chart:

 

The modified Marsh classification of gluten-induced small-intestinal damage [33,34] (taken from Open Original Shared Link )

• Stage 0 - Preinfiltrative mucosa; up to 30% of patients with dermatitis herpetiformis (DH) or gluten ataxia have small-intestinal biopsy specimens that appear normal
• Stage 1 - Increase in the number of intraepithelial lymphocytes (IELs) to more than 30 per 100 enterocytes
• Stage 2 - Crypt hyperplasia. In addition to the increased IELs, there is an increase in crypt depth without a reduction in villus height. Gluten challenge can induce these changes, which can also be seen in 20% of untreated patients with dermatitis herpetiformis and celiac disease
• Stage 3 - Villous atrophy: A, partial; B, subtotal; C, total. This is the classic celiac lesion. It is found in 40% of DH patients. Despite marked mucosal changes, many individuals are asymptomatic and therefore classified as having subclinical or silent cases. This lesion is characteristic of, but not diagnostic of, celiac disease and can also be seen with severe giardiasis, infantile food sensitivities, graftversus-host disease, chronic ischemia of the small intestine, tropical sprue, immunoglobulin deficiencies, and other immune deficiencies and allograft rejection