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Is this a positive biopsy?!

ABJ08
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ABJ08 Newbie
ABJ08
Posted

I received my biopsy reports from an extensive EDG and Colonoscopy I had to have due to a previous biopsy coming back precancerous. 
 

They took a biopsy to rule out celiac disease however the Google button is making me come to the conclusion it’s positive and I absolutely can not wait till my follow up to find out.

 

the report reads: intact villi are significant for intraepithelial lymphocytes and partial villous blunting of lymphocytes 

Does this mean positive? 

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trents Grand Master
trents
Posted

Sounds like what you would find with celiac disease that was not at a super advanced stage since the villi are intact.

RMJ Mentor
RMJ
Posted

Yes, extra intraepithelial lymphocytes and villous blunting are both signs of celiac disease. 

Have you had any of the antibody blood tests for celiac disease?

ABJ08 Newbie
ABJ08
Posted
  • Author

I haven’t had any blood work done for celiac disease since it has never been on my list to look for. I’ve been trying to figure out what’s wrong with me for atleast 10 years now and it wasn’t till having this last EGD with my new gastro doc that it was even brought up so this is all new territory for me.

trents Grand Master
trents
Posted

So, in case your gastro doc wants to do the blood antibody tests, you need to continue eating regular amounts of gluten until after the blood draw. The antibody tests usually come first and the biopsy is done for confirmation but just in case . . .

Scott Adams Grand Master
Scott Adams
Posted

I agree, the biopsy result suggests that there are increased intraepithelial lymphocytes (IELs) present, which is a common finding in celiac disease. The partial villous blunting indicates that there is some damage to the villi, although they are not completely flattened. This combination of findings is consistent with early or mild celiac disease.

  • 1 month later...
ABJ08 Newbie
ABJ08
Posted
  • Author

So I finally got my results and Im so confused and disappointed I’m back to square 1 of no answers!! Has anyone else dealt with this on the result aspect? 
 

IGg A was 265 ref mg/L 87/352

Tt Iga ab -negative 

bx celiac suggested

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RMJ Mentor
RMJ
Posted

That isn’t a complete blood panel for celiac disease. Can you ask for additional tests? Especially Deamidated gliadin peptide (DGP) IgA?

ABJ08 Newbie
ABJ08
Posted
  • Author

I guess idk what a complete panel would all entail I thought that’s what they were doing since the pathologist for my biopsy stated to do a celiac work up based on what he say. I can see if I can request it however this gastro doc told me “all these test are normal, no need to follow up, follow up as needed” soooo yeah

trents Grand Master
trents
Posted

ABJ08, are you sure you typed that "IGg A was 265 ref mg/L 87/352" correctly? "IGg A" is not a familiar abbreviation, though the magnitude of the numbers makes it look like it refers to total IGA. A total IGA test is often run in conjunction with the TTG-IGA because if total IGA is low it will skew the TTG-IGA down toward the negative range.

Question. When the blood draw for these tests was done, had you been eating plenty of gluten on a regular basis?

I would request a more complete celiac antibody panel including DGP-IGA and DGP-IGG.

Scott Adams Grand Master
Scott Adams
Posted

You can still have celiac disease with negative blood test results: 

Clinical and genetic profile of patients with seronegative coeliac disease: the natural history and response to gluten-free diet:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5606118/ 

Seronegative Celiac Disease - A Challenging Case:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9441776/ 

Enteropathies with villous atrophy but negative coeliac serology in adults: current issues:
https://pubmed.ncbi.nlm.nih.gov/34764141/ 

 

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    • daniellelawson2011
      Lab results

      By daniellelawson2011 · Posted

      Thank you for the welcome and reply. The first test was tissue transglutaminase IGA and it was normal. The second test just simply says IGA and it was 638. You definitely answered my question, it sounds like im negative for celiac since the 1st test was normal, and that another condition has caused the abnormal result of the IGA. That's exactly what I was wondering. Im almost positive I have MS and I've read results are higher like that with early onset. Or it could be IBS. Hopefully the visit with the neurologist will give me even more answers and point to a final diagnosis. I really appreciate you taking the time to reply and for helping. Thank you so much!
    • trents
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      By trents · Posted

      Welcome to the forum, @daniellelawson2011! First, we need to deal with terminology here. When you refer to the "ttg" test I take that to mean the ttg-iga. And when you refer to the "iga" test I take that to mean total iga since the magnitude of the score would suggest that. Total iga is not a test for celiac disease per se. It is run in order to check for iga deficiency. If you are iga deficient, then the ttg-iga and other iga tests that are specific for celiac disease will be abnormally low and this would potentially produce false negatives. You are not iga deficient but, rather, your total iga is abnormally high. This can suggest underlying health conditions, some of them can be serious in nature.  https://labs.selfdecode.com/blog/high-iga/ "High IgA usually points to chronic infections or inflammation, though many disorders can raise its levels. High IgA does not cause symptoms. People show symptoms from their underlying health problem." One thing I might add and that is you must have been eating normal amounts of gluten for weeks/months prior to the blood draw for antibody testing. Testing while on a gluten free or gluten reduced diet will not yield valid results. Also, here is a primer outlining the various antibody tests that can be ordered to check for celiac disease:  
    • daniellelawson2011
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      By daniellelawson2011 · Posted

      After struggling with many different symptoms for years with no diagnosis, I decided to do my own research and I stumbled upon an article about celiac disease. I asked my PCP to order a ttg and iga. The results: the iga was high at 638. The ttg was negative. Of course I will discuss with my doctor, but i would like to hear from people that have went through the process of diagnosis to maybe give me some insight on what this means and where to go from here. Also of note, i had a brain mri which showed white lesions which arent typical at 44 years old. I have many MS symptoms. I go to the neurologist on Tuesday, but just curious if anyone knows if there is a correlation between iga and MS. I appreciate any help! Thanks!
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      Thank you for your advice. I appreciate the help. 
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