Help understanding blood test and biopsy result! I’m confused!

[Looneykoko]

Hi! 

So I went to a GI doctor due to having terrible digestive issues, bloating, and acid reflux. I got a celiac blood panel test done and only one part came back positive, the Deamidated Gliadin Abs, IgG. my doctor then told me that an endoscopy needs to be performed next so i got one done. (Both blood test and endoscopy were performed while i was eating gluten) The biopsy results were “ increased intraepithelial lymphocytes with normal villous structure”. I met with my doctor and she stated with the blood results combined with the biopsy results that it was celiac disease. she told me to go gluten-free and come back in two months to get another blood test. so I went gluten free and it’s been one month since, and I have seen a big difference in symptoms, with me almost having no digestive issues now. 

i’m just confused because I’m trying to understand the results more and I looked stuff up and I’m reading stuff about latent Celiac, only gluten intolerant, etc. i’m just questioning it because I have no intestinal damage, but I do know that not every part of the intestines can be biopsied to see. and the only one positive part blood test is confusing to me, because some sources say only one antibody needs to be positive and some don’t. I don’t want to be diagnosed celiac if I don’t have it, but on the other hand I do want to be diagnosed if I do have it because I don’t want to make it worse if i don’t do gluten free. 
obviously I trust my doctor and she has been really great at listening to me, and i’m going to meet with her soon to ask for clarification. I’m not asking for a diagnosis, but I’m just trying to see if anybody else has had the same experience or results? Or if anybody can help explain the results more? I know I’m probably overthinking it😅

[trents]

Negative test results, especially those in the IGA family, can be caused by low total IGA counts. It's good that your doctor ran a full celiac panel that can detect celiac disease in this situation. Also, some people's immune response to celiac disease is atypical. This might help in understanding what tests can be run for celiac disease and the strength and weaknesses of each. The most common test run is the tTG-IGA and man docs will only order that one because it combines good sensitivity with good specificity. But sometimes it misses: https://celiac.org/about-celiac-disease/screening-and-diagnosis/screening/

[Scott Adams]

It looks like your doctor has made the right diagnosis based on the blood test and “increased intraepithelial lymphocytes” in your biopsy. Going gluten-free is your next step.