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IgG Ab positive and weird endoscopy report

abtwin26
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Go to solution Solved by Wheatwacked,

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abtwin26 Newbie
abtwin26
Posted

Hello, I recently had blood work done and was negative for IgA put positive with IgG.  Then I had a endoscopy which showed intestinal metaplasia; consistent with atrophic/autoimmune
gastritis.  (All result below)

My doctor said that is also a positive for Celiac and said I should continue on a gluten free diet.  So, am I truly Celiac and should I be on a strict diet?   I am worried about the endoscopy since we have colon cancer in the family also.  Thanks for any help.

Gliadin IgG Antibody, Quant
View trends
Normal value: <15 U/mL
Value
17High
Gliadin IgG Ab, Interpretation
View trends
Normal value: Negative
Value
POSITIVE Abnormal
(NOTE)
This assay measures deamidated gliadin IgG peptides.

 

Diagnosis:
 
A. Duodenal bulb, biopsy: Focal gastric antral epithelium/metaplasia,
a finding associated with peptic duodenitis.
 
-No infectious pathogens identified.
 
-Negative for adenoma/dysplasia or malignancy.
 
 
B. Antrum, biopsy: Chemical/reactive gastropathy; mild chronic
gastritis; intestinal metaplasia; consistent with atrophic/autoimmune
gastritis.

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trents Grand Master
trents
Posted
(edited)

I could be wrong but the pathology report doesn't seem to describe the kind of damage to the lining of the small bowel caused by celiac disease that we normally see. Celiac disease causes a blunting of the villi. It wears them down and reduces the nutrient absorbing efficiency of what starts out to be millions and millions of tiny finger-like projectiles.

When you had the bloodwork done, were you already on a reduced gluten diet by some chance. Which IGA test was done? Can you be more specific? There is: total IGA, TTG-IGA and DGP-IGA that can be run when testing for celiac disease. It's really important to run the total IGA test along with the TTG-IGA test because of total IGA is low it can result in false negatives for the TTG-IGA. The TTG-IGA test is considered to be the centerpiece of celiac disease antibody testing. The DGP-IGP test which was your positive one is a little less specific for celiac disease but is often helpful in the situation where people are IGA deficient or have been on a reduced gluten diet.

I would also note that the pathology report stated you were negative for "adenoma/dysplasia or malignancy". In other words, no sign of cancer.

You could also be looking at NCGS (Non Celiac Gluten Sensitivity) which shares many of the same symptoms with celiac disease but does not damage the villous lining of the small bowel. It is 10x more common than celiac disease but there is no test for it yet. celiac disease must first be ruled out. Both conditions require lifelong abstinence from gluten.

What symptoms are you experiencing that motivated you to get checked for celiac disease?

Edited by trents
Scott Adams Grand Master
Scott Adams
Posted

This article might be helpful. It breaks down each type of test, and what a positive results means in terms of the probability that you might have celiac disease. 

 

 

  • Solution
Wheatwacked Veteran
Wheatwacked
Posted
  • Solution
21 hours ago, abtwin26 said:

My doctor said that is also a positive for Celiac and said I should continue on a gluten free diet. 

 

21 hours ago, abtwin26 said:

So, am I truly Celiac and should I be on a strict diet?

Yes. And also assume you have vitamin deficiencies.

21 hours ago, abtwin26 said:

B. Antrum, biopsy: Chemical/reactive gastropathy; mild chronic
gastritis; intestinal metaplasia; consistent with atrophic/autoimmune
gastritis.

Gastric metaplasia: a frequently overlooked feature of duodenal biopsy specimens in untreated celiac disease

abtwin26 Newbie
abtwin26
Posted
  • Author

Thank you for all the help.  I did have 6 blood tests in total, 4 negative and 2 positives.  I did try and look at the article noted for blood tests results, but just could not understand it.  The last response was what I was looking for and made sense to me.  Seems as Celiac is not such a cut and dry diagnoses.  Lots to learn and thank you again.  

trents Grand Master
trents
Posted
(edited)

If you had four positive out of six celiac antibody tests and there was inflammation in your duodenum as the pathology report stated, I would say that is pretty conclusive for celiac disease. You may have caught it early enough before villi blunting was happening.

Edited by trents
abtwin26 Newbie
abtwin26
Posted
  • Author

Thanks Trents!  To the recipe area for me:)

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      Welcome to the forum! Keep in mind that if you quit eating gluten before all testing is done, you may have inaccurate, possibly false negative, test results.  When you stop eating gluten, your body stops making the antibodies which are measured in the blood tests.  Stopping gluten before an endoscopy may make the intestinal damage harder to detect, and a false negative biopsy may result.  As uncomfortable as it is, finish all testing before going gluten free.  
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      Here is more info about how to do a gluten challenge for a celiac disease blood panel, or for an endoscopy: and this recent study recommends 4-6 slices of wheat bread per day:    
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      Welcome to the forum, @Whyz! By "half way to being diagnosed" I assume you mean you have had the blood antibody testing done but not the gastroscopy with biopsy. Is this correct? Were the results of your blood work positive for celiac disease?
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