Jump to content
This site uses cookies. Continued use is acceptance of our Terms of Use and Privacy Policy. More Info... ×

  • Welcome to Celiac.com!

    You have found your celiac tribe! Join us and ask questions in our forum, share your story, and connect with others.



  • Celiac.com Sponsor (A1):

    Celiac.com Sponsor (A1-M):

  • Get Celiac.com Updates:
    Support Our Content
    eNewsletter
    Donate

Which Will Show Up First?

sarahelizabeth

Recommended Posts

sarahelizabeth Contributor
sarahelizabeth
Posted

(I meant to post this in here ;))

A positive blood test or a positive biopsy??

I guess my question is does the intenstinal damage cause the bloodwork to show ++ or does the presense of the antibodies in the blood cause the intestinal damage?? Does that make sense at all??

Can you have ++ bloodwork and a negative biopsy?? And can you have neg bloodwork and a pos biopsy??

Celiac.com Sponsor (A8):
Celiac.com Sponsor (A8):

Celiac.com Sponsor (A8-M):


Ursa Major Collaborator
Ursa Major
Posted
(I meant to post this in here ;))

A positive blood test or a positive biopsy??

I guess my question is does the intenstinal damage cause the bloodwork to show ++ or does the presense of the antibodies in the blood cause the intestinal damage?? Does that make sense at all??

Can you have ++ bloodwork and a negative biopsy?? And can you have neg bloodwork and a pos biopsy??

Generally, the intestinal damage will cause the antibodies to show up in the blood.

But many here have had positive bloodwork and a negative biopsy (damage is easily missed), and there are others who've had negative bloodwork and a positive biopsy. The bloodwork is not terribly reliable. Which shows that neither one is very reliable, and trying the diet is the best test of them all. Because if you aren't intolerant to gluten, you won't get better. But if you are intolerant, the diet will make a big difference in your wellbeing.

JennyC Enthusiast
JennyC
Posted

Theoretically the blood work should show up first. The tTG test looks for tTG antibodies which is indicative of an autoimmune response occurring in the body. The result of that autoimmune response is the release of chemicals from immune cells that damage the intestine. This causes the flattened villi that is observed during a positive biopsy. From what I have read here it seems that there has to be a large amount of antibody circulating in the blood for the tTG test to be positive, so realistically both tests should be positive at about the same time.

Many people have had different combinations of positive and negative results--just read the signature lines! Medical opinions also differ widely.

momof2sn Apprentice
momof2sn
Posted
Theoretically the blood work should show up first. The tTG test looks for tTG antibodies which is indicative of an autoimmune response occurring in the body. The result of that autoimmune response is the release of chemicals from immune cells that damage the intestine. This causes the flattened villi that is observed during a positive biopsy. From what I have read here it seems that there has to be a large amount of antibody circulating in the blood for the tTG test to be positive, so realistically both tests should be positive at about the same time.

Many people have had different combinations of positive and negative results--just read the signature lines! Medical opinions also differ widely.

My daughter had negative biopsy and positive blood work. The ped GI did biopsy first and mistakingly forgot to do the blood work at the same time so a month later we had blood work and it was positive.

gfp Enthusiast
gfp
Posted
Generally, the intestinal damage will cause the antibodies to show up in the blood.

But many here have had positive bloodwork and a negative biopsy (damage is easily missed), and there are others who've had negative bloodwork and a positive biopsy. The bloodwork is not terribly reliable. Which shows that neither one is very reliable, and trying the diet is the best test of them all. Because if you aren't intolerant to gluten, you won't get better. But if you are intolerant, the diet will make a big difference in your wellbeing.

Blood work can be unreliable but usually because the correct procedures are followed...

When they are and a FULL suite is taken they are over 98% reliable....

Its not that you are wrong.. unfortunately your correct... but that is largely down to the MD's who don't realise we need to eat gluten or MD's who only specify partial tests etc.

Hassi-----zzgxz has a paper somewhere where they managed to get some dead bodies and do post mortems (He has so many I can't find it right now)... but the correleation between blood and post mortem examination of villi was 98%+...

This is the other problem on reliability of blood tests.... many +ve blood tests and negative biopsy and instead of the Dr. accepting they missed the damaged villi they say the blood tests are inacurrate.... add to this the numbers done on children where we know them to be unreliable...

Its completely possible of course there are better tests and the current full panel does miss the odd person... even under the best circumstances.... but I just wanted to say the IMPORTANT thing is to do it correctly... if you don't get a full panel and its -ve its pretty useless.... +ve always means positive (except for 1:10,000 of human error) ... even if its just to some degree but -ve can mean bad procedures, not eating gluten, patient too young... etc. etc.

JennyC Enthusiast
JennyC
Posted
This is the other problem on reliability of blood tests.... many +ve blood tests and negative biopsy and instead of the Dr. accepting they missed the damaged villi they say the blood tests are inacurrate.... add to this the numbers done on children where we know them to be unreliable...

This is what the gastro that I took my son to tried to say. My son's tTG levels were 3x higher than normal and he had normal IgA and IgG. His pediatrician who ordered the tests told me to put him on a gluten-free diet, and by the time I went to see the gastro it was a month later. The gastro was pushing very hard for the gluten challenge and biopsy. He said that if the biopsy was negative that he did not have the disease and he could continue to eat gluten. He also said that celiac disease is not a spotty disease. Well, it's not to him if he has that opinion! <_< I was SO mad when I left his office. I will never go back to him again. I am waiting for another appointment for a second opinion, but honestly I do not expect much better from the next doctor.

Archived

This topic is now archived and is closed to further replies.

Go to topic listing
  • Celiac.com Sponsor (A19):


  • Member Statistics

    • Total Members
      130,563
    • Most Online (within 30 mins)
      7,748
    Judi Ronan
    Newest Member
    Judi Ronan
    Joined
  • Celiac.com Sponsor (A20):

  • Forum Statistics

    • Total Topics
      121.3k
    • Total Posts
      1m
  • Celiac.com Sponsor (A22):



  • Celiac.com Sponsor (A21):


  • Upcoming Events

  • Posts

    • Wamedh Taj-Aldeen
      Positive TTG antibody and negative EMA antibody

      By Wamedh Taj-Aldeen · Posted

      I recently reviewed a patient with a positive tissue transglutaminase (tTG) antibody but negative endomysial antibodies (EMA). The patient is asymptomatic, and duodenal biopsies—taken while on a normal gluten-containing diet—were reported as normal. Given the discordant serology and absence of histological changes, I understand that the probability of coeliac disease is low. However, I would appreciate your guidance on the following: Is routine follow-up required in such a case? What is the risk of progression to overt coeliac disease in the future? Would HLA DQ2/DQ8 typing be useful here to help guide long-term management or exclude the diagnosis confidently? I would be grateful for your thoughts.
    • trents
      Is "Shield" skincare products gluten-free?

      By trents · Posted

      @LynnM, when you say, "today, his numbers were high", what numbers do you refer to? Are you speaking of celiac antibody scores? Can you be more specific and can you post the test names, the numbers and the reference ranges for the tests? So, I am understanding you to say that topical exposure to gluten doesn't cause him GI reactions but ingestion of gluten does but at the same time you are attributing the "high numbers" to the topical exposure?
    • Ginger38
      Abnormal Labs, Should I Be Concerned?

      By Ginger38 · Posted

      So I recently had blood work and my hemoglobin, hematocrit, protein and alkaline phosphatase were all low. They have never been low in the past but since august of last year I have been on the in and off gluten rollercoaster as I mentioned in previous posts. Should I be concerned with these new findings? I am worried I have made myself really sick and done damage or something this past year 
    • LynnM
      Is "Shield" skincare products gluten-free?

      By LynnM · Posted

      Thank you Scott. My son doesn't have a reaction topically, only when ingested. Interestingly though, the doc told us the face cream getting gluten into his bloodstream doesn't do the damage akin to when gluten is ingested. He had no reaction when using the face cream, it only presented in blood-work. I'm hopeful from all the comments today and will wait for the GI doc to reply. If he is cleared to use it, I will encourage SHIELD to get a gluten-free certification 
    • Scott Adams
      Is "Shield" skincare products gluten-free?

      By Scott Adams · Posted

      It’s great that you’re taking the time to research products carefully for your son with celiac disease—especially since accidental gluten exposure through skincare can be a real concern for sensitive individuals. Based on the ingredient lists you’ve shared, none of the products appear to contain obvious sources of gluten like wheat, barley, or rye derivatives. Ingredients like glycerin and tocopherols (not listed here but often a concern) can sometimes be derived from wheat, but many manufacturers use plant-based or synthetic sources. SHIELD’s transparency and willingness to share their full ingredient list is a good sign, and their note about not intentionally adding gluten is reassuring. Still, because ingredient sourcing can vary and sensitivities differ from person to person, it’s wise that you’ve reached out to your GI specialist to be sure these products are safe for your son’s specific needs. In the meantime, if you do try any of the products, consider patch-testing them first and watching closely for any signs of skin irritation or reactions. PS - Most people with celiac disease won't react to skin products that may contain gluten, but I still recommend finding gluten-free products.
×
×
  • Create New...