Biopsy negative?

[LSB]

After battling symptoms such as bloating, excessive gas, belching, burbing, multiple bathroom trips, etc. I finally read online that celiac disease is hereditary. My sister was diagnosed years ago but never told me that I should be tested too. 

After more negative ultrasounds  to try and find out the problem, I asked if it could be possible I had celiac. My PCP promptly ordered bloodwork which came back as follows:

Deamidated Glidea Abs, IgA  20 units

t-Transglutaminase (tTG)   < 2 U/mL

Immunoglobulin A, QN Serum 242 mg/ul

My biopsy came back negative, but I had stopped eating gluten 5 days prior to the tests. 

I also tested positive for h pylori which I feel overshadowed the celiac biopsy? 

Now, I have to take antibiotics and have a repeat endoscopy in 3 months... 

Now what? Do I go back to eating gluten, do I request retesting? 

Here are lab ranges:

Qn, Serum

242^NORMAL

 

 

Ref Range:87-352 mg/dL

Deamidated Gliadin Abs, IgA

20^HIGH

 

 

Ref Range:0-19 units

Negative 0 - 19 Weak Positive 20 - 30 Moderate to Strong Positive >30

t-Transglutaminase (tTG) IgA

<2

Ref Range:0-3 

Negative 0 - 3 Weak Positive 4 - 10 Positive >10 . Tissue Transglutaminase (tTG) has been identified as the endomysial antigen. Studies have demonstr- ated that endomysial IgA antibodies have over 99

GI report in part reads: Scattered mild inflammation characterized by congestion, erythema, and mild scallop in in few mucosa folds of the 2nd portion of the duodenum. A shallow ulcer was found in duodenal bulb. Biopsies for histology were taken for evaluation of celiac disease.

[squirmingitch]

You have not included any ranges for the serum tests. Each lab is different so ranges need to be posted so we can tell if they were positive or negative. Were you gluten free for 5 days prior to the serum panel?

On the endoscopy, how many biopsies were taken & from what areas?. 

[cyclinglady]

I agree!  Many of the pieces of the puzzle are missing.  

1.  You can have both H.Pylori and celiac disease.  We are talking stomach vs.  small intestine.  

2.  Where were the biopsies taken?  How many?  Get the pathologist’s report and the endoscopy report.  It is your RIGHT!  

3.  Ugh!  I hope your doctor did not advise you to go gluten free before all testing was complete.  Five days should not have mattered....but it is possible.  The small intestine is the size of a tennis court and celiac can be patchy.  I had patches of moderate to severe damage.  

4.  First-degree relatives should be screened every few years, unless you get a genetic test showing that you were lucky and did not inherit the celiac genes.  

I hope this helps!  

[LSB]

I added the lab ranges. Preliminary dx on gi report was gastritis and duodentis 

[cyclinglady]

Thanks for posting the additional information.  

I think you have to wait for the pathologist’s report because 1) I am not a doctor and 2) I could be just a crazy cyclist stalking the internet!   ?Celiac disease damage can be microscopic.  Some GI’s have access to really good scopes and can visually see damage while others (like my old GI) have an older scopes).  Your GI noted inflammation and scalloping which can be celiac disease.  My visual was fine.  No inflammation even noted, but my biopsies revealed a Marsh Stage IIIB.  

Like you, I only had a positive on the DGP IgA.  Even in follow-up testing, I have never had a positive on the EMA or TTG.  My anemia resolved within a few months on the gluten free diet and that really confirmed my diagnosis.  

Now you just need to wait and be patient.  So hard, I know!  In the meantime, take those antibiotics and beat back that H. pylori and let that ulcer heal!