How confident should I be with these results?

[orion]

Hi folks,

I went in to see a gastroenterologist in the beginning of December due to ongoing reflux and digestive issues that cropped up a month or so prior. I was put on omeprazole and carafate and scheduled for an upper endoscopy and colonoscopy in January. There were no visible issues found during that procedure, but they also biopsied my stomach, small intestine and colon. Stomach and colon were normal but the small intestine had "increased itraepithelial lymphocytes, and villous blunting" with a note of "histology could be seen in the setting of sprue." 

Based on that finding, my doctor said suggested it could be celiac disease and ordered additional labs. I had a celiac disease panel and HLA dna testing done and I just got those results back yesterday. The blood panel included Endomysial Antibody IgA, t-Transglutaminase (tTG) IgA, and Immunoglobulin A, Qn, Serum.  The Endomysial Antibody IgA was negative, the t-Transglutaminase (tTG) IgA was "weak positive" 4 (reference ranges were 0-3 negative, 4-10 weak positive, >10 positive), and Immunoglobulin A, Qn, Serum was 217 (reference range 90-386 is normal). 

The HLA test showed I was positive for HLA-DQ2 (DQA1*02:AC,05:BPGVU positive, one copy | DQB1*02:CHJSJ,03:BZUXK positive, one copy). Since my parents have both done 23andme tests, I know that my mother doesn't have any celiac genes, but my father has an HLA-DQB1 variant, and apparently my great uncle on his side has Celiac disease. Of course no one told me any of this until my own tests came up, lol.

My doctor told me that while it would have been a home run if my labs were higher, my results were enough to diagnose me with Celiac disease and for me to go ahead and start a gluten-free diet. I'll have follow-up appointments at 3 and 6 months, with a repeat biopsy around a year out. I'm also supposed to be setting up an appointment with a nutritionist/dietitian. 

I'm very new to all of this, so I just wanted to get a feel for if my results are just borderline and could be something else or if I can be reasonably confident in the diagnosis.

Thanks!

- Jake

 

Edited February 5, 2020 by orion

[Scott Adams]

We can't officially diagnose you from this info, but certainly the villi damage along with positive tests, even weak positive blood test results, together are probably a good sign that you're on the right track by going gluten-free. If your digestive issues resolve on the diet it would be a slam dunk, but you need to be certain that your diet is 100% gluten-free, which isn't as simple as it sounds.

[Fenrir]

As Scot says we can't diagnose you but 98% of people that are positive (weak or strong doesn't matter)for TTG IgA are celiacs. 

The quote you posted from the pathology report (I used work with pathologists as a lab tech) would indicate you have Celiac Disease (that's what they mean by sprue). 

IMO, and I'm no doctor, is that you have a very solid diagnosis of celiac disease. You have positive blood tests and a pathology report suggesting celiac disease.