Which Will Show Up First?

[sarahelizabeth]

(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??

[Ursa Major]

(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]

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]

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]

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]

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.