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Doubting Dr. Thomas


L.A.

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L.A. Contributor

My gastro guy is having issues commiting 100% to me having celiac disease <_< . A specialist did the blood test which came back positive for Celiacs. My gastro guy decided to do a biopsy and it was negative. Is the blood test proof positive?


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mouse Enthusiast

Yes, it is. You can never have a false positive, but you can have a false negative. Many doctors still think of the biopsy as the gold standard. The problem with it, is if he does not take enough biopsies from the right areas, then the test can be negative. I only had the blood test and never the biopsy. But, I had also become the "classic celiac" before the diagnosis. So, my doctor did not think it was necessary for me to have it done.

Phila Rookie

My doc diagnosed me based on symptoms alone, but then again I had a tonne of symptoms. He's a huge proponent of looking at dietary response to come to a diagnosis. I must say that I do regret not having all of the tests, although I am absolutely convinced I have celiac disease.

Today was actually a scary day for me. My prolactin levels are high again so doc has ordered a CT scan to check for a pituitary tumour. I'd been having a tonne of issues lately which I thought were biliary related, but my doc seems to have dismissed that. He's worried about the prolactin and kept staring at those numbers.

Guest nini

a pos. blood test is absolutely proof positive... just because the biopsy didn't find anything, it doesn't mean diddly squat... you have Celiac... welcome to the club! Get on with the business of getting well.

I was dx'ed on positive blood work and positive dietary response alone, I did not have a biopsy at all... my Dr. had said that since my blood work was positive I absolutely have it and did not need to go through a biopsy to confirm it.

Guest Robbin
My doc diagnosed me based on symptoms alone, but then again I had a tonne of symptoms. He's a huge proponent of looking at dietary response to come to a diagnosis. I must say that I do regret not having all of the tests, although I am absolutely convinced I have celiac disease.

Today was actually a scary day for me. My prolactin levels are high again so doc has ordered a CT scan to check for a pituitary tumour. I'd been having a tonne of issues lately which I thought were biliary related, but my doc seems to have dismissed that. He's worried about the prolactin and kept staring at those numbers.

:( I am sorry you have been having these problems. I haven't seen you post before, so welcome.

Also, ditto for me--the positive bloodwork means just that--positive. Why the medical community does this "song and dance act" around diagnosing this disease, is beyond me.

jayhawkmom Enthusiast

I'm very new here, and still wondering around just reading, reading, and reading. I came across this and wanted to ask, where do you think my daughter fits in here?

For reference purposes - the lab we used gave us the following information as THEIR norms. I realize other labs have other standards.

Ttg - <5 (my daughter's was 4)

IgA - <10 (hers was 9)

IgG - <11 (hers was 72)

EMA - Negative (no number provided)

Total IgE <20 - (hers was over 100 - 170 if I correctly recall)

Positive SPT - wheat/egg

Positive RAST - wheat/egg

(She has other allergies as well)

Negative biopsy for Villi damage, however... she has duadenal ulcers that I'm told are consistant with Celiac.

So, is she.... or isn't she?

She wasn't diagnosed Celiac. She was diagnosed with a Gluten Intolerance. What's the difference? Nothing, as far as the diet is concerned, right??

Thanks!

aikiducky Apprentice

You're right, gluten intolerance means exactly the same diet-wise as celiac, and you need to exactly as careful about cross-contamination, too.

"Celiac" is a name that the doc gives to a disease when all the symptoms and test results are present that the medical community has agreed on have to be there. So when the test results and symptoms aren't exactly according to that list, but it's obvious that gluten is a problem, they call it "gluten intolerance" instead to be completely PC. You need to realize that the definition of "celiac" keeps changing, so in the future, someone with the exact same picture as your daughter may well get diagnosed celiac. They keep changing the definition as more information comes available with reseach, but that of course happens slowly.

Pauliina


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    • trents
      So the tTG-IGA at 28 is positive for celiac disease. There are some other medical conditions that can cause elevated tTG-IGA but this is unlikely. There are some people for whom the dairy protein casein can cause this but by far the most likely cause is celiac disease. Especially when your small bowel lining is "scalloped". Your Serum IGA 01 (aka, "total IGA") at 245 mg/dl is within normal range, indicating you are not IGA deficient. But I also think it would be wise to take your doctor's advice about the sucraid diet and avoiding dairy . . . at least until you experience healing and your gut has had a chance to heal, which can take around two years. After that, you can experiment with adding dairy back in and monitor symptoms. By the way, if you want the protein afforded by dairy but need to avoid casein, you can do so with whey protein powder. Whey is the other major protein in dairy.
    • jenniber
      hi, i want to say thank you to you and @trents   . after 2 phone calls to my GI, her office called me back to tell me that a blood test was “unnecessary” and that we should “follow the gold standard” and since my biopsy did not indicate celiac, to follow the no dairy and sucraid diet. i luckily have expendable income and made an appt for the labcorp blood test that day. i just got my results back and it indicates celiac disease i think 😭   im honestly happy bc now i KNOW and i can go gluten free. and i am SO MAD at this doctor for dismissing me for a simple blood test that wouldn’t have cost her anything !!!!!!!!!!! im sorry, im so emotional right now, i have been sick my whole life and never knew why, i feel so much better already   my results from labcorp:   Celiac Ab tTG TIgA w/Rflx Test Current Result and Flag Previous Result and Date Units Reference Interval t-Transglutaminase (tTG) IgA 01 28 High U/mL 0-3 Negative 0 - 3 Weak Positive 4 - 10 Positive >10 Tissue Transglutaminase (tTG) has been identified as the endomysial antigen. Studies have demonstrated that endomysial IgA antibodies have over 99% specificity for gluten sensitive enteropathy. Immunoglobulin A, Qn, Serum 01 245 mg/dL 87-352
    • JoJo0611
      Thank you this really helped. 
    • Samanthaeileen1
      Okay that is really good to know. So with that being positive and the other being high it makes sense she diagnosed her even without the endoscopy. So glad we caught it early. She had so many symptoms though that to me it was clear something was wrong.   yeah I think we had better test us and the other kids as well. 
    • GlorietaKaro
      One doctor suggested it, but then seemed irritated when I asked follow-up questions. Oh well—
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