Awaiting diagnosis

[jlp1999]

Hello,

I am awaiting an appointment with my gastroenterologist. A routine endoscopy for stomach pain showed villous atrophy on the biopsy. Follow up bloodwork showed the IGA was within normal limits but the IGG was a weak positive. I know villous atrophy can be caused by other things, with a normal IGA could this mean it's not celiac? 

Thanks for the info

[trents]

Welcome to the forum, @jlp1999!

Which IGA test do you refer to as being normal? TTG-IGA? Total IGA? DGP-IGA?

Yes, any positive on an IGA or an IGG test can be due to something other than celiac disease and this is especially true of weak positives. Villous atrophy can also be cause by other things besides celiac disease such as some medications, parasitic infections and even some foods (especially dairy from an intolerance to the dairy protein casein). But the likelihood of that being the case is much less than it being caused by celiac disease.

Edited April 12, 2025 by trents

[jlp1999]

Thank you for the reply. It was the TTG IGA that was within normal limits

[trents]

Were you consuming generous amounts of gluten in the weeks leading up to the blood draw for the antibody testing? And was there a Total IGA test done to test for IGA deficiency?

Edited April 12, 2025 by trents

[jlp1999]

There was not a total IGA test done, those were the only two ordered. I would say I was consuming a normal amount of gluten, I am not a huge bread or baked goods eater

[trents]

I would ask for a total IGA test (aka, Immunoglobulin A (IgA) and other names as well) to check for IGA deficiency. That test should always be ordered along with the TTG IGA. If someone is IGA deficient, their individual celiac IGA test scores will be artificially low which can result in false negatives.

Make sure you are eating generous amounts of gluten leading up to any testing or diagnostic procedure for celiac disease to ensure validity of the results. 10g of gluten daily for a period of at least 2 weeks is what current guidelines are recommending. That's the amount of gluten found in about 4-6 slices of wheat bread.