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zarfkitty

Study About Biopsies - False Negatives Possible

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apologies if anyone has already posted this:

The Absence of a Mucosal Lesion on Standard Histological

Examination Does Not Exclude Diagnosis of Celiac Disease.

Dig Dis Sci. 2007 May 9;

Mohamed BM, Feighery C, Coates C, O'shea U, Delaney D, O'briain S,

Kelly J, Abuzakouk M Some patients with undiagnosed celiac disease

have minor mucosal lesions that may not be apparent during routine

histological analysis. Twenty-five such patients of our institution were

discharged to their primary-care physicians despite having positive

endomysial antibody serology. To re-evaluate diagnosis for these patients,

immunohistological staining with antibodies to CD2, CD3, CD7, CD8, CD69,

and Ki67 was conducted on original biopsies from twenty patients.

Clinical, serological, and histological investigations were offered to all

fourteen patients who attended for review. We observed a significantly

greater (P < 0.0001) numbers of intraepithelial lymphocytes and

Ki67-positive enterocytes in sections from these twenty patients than for normal

controls. Of the fourteen patients who attended for further review,

firm diagnosis of celiac disease was made for seven patients and

diagnosis was likely for another two. Our study clearly revealed that

over-reliance on standard histological findings results in failure to

diagnose celiac disease.

emphasis mine


gluten-free May 17, 2007; casein-light since June 2007

Dx'ed gluten/casein intolerant by Enterolab. Family doc dx'ed "gluten sensitive" after dietary response. DQ 6 & DQ 7

8 year old daughter dx'ed gluten/casein intolerant & malabsorption by Enterolab and has been GFCL since June 12, 2007. Excellent response to diet, including growth! Tummyaches & irritability are gone! DQ 5 & DQ 6

Husband has DQ 5 (elementary, my dear Watson!). Self-diagnosed gluten-intolerant by diet response and challenge.

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Thanks for posting! That is one of the many reasons that I refused to put my son through the gluten challenge.


Jenny

Son 6 yrs old, Positive blood work, Outstanding dietary response, no biopsy.

Household mostly gluten free since 3/07

Me: HLA-DQ 02 & 0302 (DQ 08), which I ran & analyzed myself!Currently gluten lite, negative tTG, asymptomatic

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I believe that I was diagnosed with just this finding, and dietary response. I had intraepithelial lymphocytes in biopsy sections but "acceptable" villi and no other visible signs in the biopsy samples. And I had negative blood tests. So my doc was good up to that point. After that, he told me that I had a "light" version of celiac and wouldn't need to be as strict. On that, he was wrong.

~Laura

apologies if anyone has already posted this:

The Absence of a Mucosal Lesion on Standard Histological

Examination Does Not Exclude Diagnosis of Celiac Disease.

Dig Dis Sci. 2007 May 9;

Mohamed BM, Feighery C, Coates C, O'shea U, Delaney D, O'briain S,

Kelly J, Abuzakouk M Some patients with undiagnosed celiac disease

have minor mucosal lesions that may not be apparent during routine

histological analysis. Twenty-five such patients of our institution were

discharged to their primary-care physicians despite having positive

endomysial antibody serology. To re-evaluate diagnosis for these patients,

immunohistological staining with antibodies to CD2, CD3, CD7, CD8, CD69,

and Ki67 was conducted on original biopsies from twenty patients.

Clinical, serological, and histological investigations were offered to all

fourteen patients who attended for review. We observed a significantly

greater (P < 0.0001) numbers of intraepithelial lymphocytes and

Ki67-positive enterocytes in sections from these twenty patients than for normal

controls. Of the fourteen patients who attended for further review,

firm diagnosis of celiac disease was made for seven patients and

diagnosis was likely for another two. Our study clearly revealed that

over-reliance on standard histological findings results in failure to

diagnose celiac disease.

emphasis mine


Diagnosed by biopsy 2/12/07. Negative blood tests. Gluten-free (except for accidents) since 2/15/07. DQ2.5 (HLA DQA1*05:DQB1*0201)

Son, age 18, previously delayed growth 3rd percentile weight, 25th percentile height (5'3" at age 15). Negative blood work. Endoscopy declined. Enterolab positive 3/12/08. Gene results: HLA-DQB1 Molecular analysis, Allele 1 0201 HLA-DQB1 Molecular analysis, Allele 2 0503 Serologic equivalent: HLA-DQ 2,1(Subtype 2,5) Went gluten-free, casein-free 3/15/08. Now 6'2" (Over six feet!) and doing great.

"Great difficulties may be surmounted by patience and perseverance." Abigail Adams (1744-1818) 2nd First Lady of the United States

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Very true. And I didn't listen to him for two reasons: 1) I'd already read this board quite a bit and was convinced that gluten-free was the only way to go and 2) my dietary response was immediate, less than 48 hours and I was feeling SO much better I could never knowingly eat wheat/gluten again.

This board rocks.

Just because your villi haven't been ripped out of your gut yet doesn't mean they're not going to be eventually! :P Light-celiac... what a joke.

Diagnosed by biopsy 2/12/07. Negative blood tests. Gluten-free (except for accidents) since 2/15/07. DQ2.5 (HLA DQA1*05:DQB1*0201)

Son, age 18, previously delayed growth 3rd percentile weight, 25th percentile height (5'3" at age 15). Negative blood work. Endoscopy declined. Enterolab positive 3/12/08. Gene results: HLA-DQB1 Molecular analysis, Allele 1 0201 HLA-DQB1 Molecular analysis, Allele 2 0503 Serologic equivalent: HLA-DQ 2,1(Subtype 2,5) Went gluten-free, casein-free 3/15/08. Now 6'2" (Over six feet!) and doing great.

"Great difficulties may be surmounted by patience and perseverance." Abigail Adams (1744-1818) 2nd First Lady of the United States

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Oh this is so very interesting........ thanks for posting this information

I am waiting for an appointment to see my GI to discuss my biospy results. I know that my biopsy showed only raised intraepithelial lymphocytes. My endomysium is negative, but I have a slighlty raised tTG, total IgA and anti-gliadin.

I have been thinking that my biospy results were too non-specific to diagnose celiac but maybe I was wrong - what does anyone think ?

Rebz

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thank you so much for posting this.

rebz-considering villi damage can be correlated with test scores, to me, your results are indicative of a problem with gluten.

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