False Serology Positive

[marklen]

Hi,

This is particulary for the USA guys, who seem to have alot more info on this.

I had a negative endoscopy but severely positive TtG and Iga serology. Are there any other conditions that could cause this blood result?

Thank you for your time.

Kind regards,

Mark

[hathor]

How do you know it was a false positive? Sometimes there are false negatives from biopsies -- they are read wrong, not enough samples are taken, samples not taken in a damaged area, or damage is ongoing but is not yet observable in the villi. People do have an adverse reaction to gluten before damage to the villi takes place or can be observed after all. It doesn't mean there isn't a problem with gluten.

Have you tried the diet yet? If so, is there a response?

I did run across this article, indicating that a Ttg result is present in inflammatory bowel disease, and so shouldn't be relied upon solely for celiac diagnosis:

https://www.celiac.com/articles/870/1/Anti-...ease/Page1.html

What specific IgA testing did you have? There are different kinds. You might look through all the articles on this web site about different tests and the specificity and sensitivity of each.

[Gemini]

Hi,

This is particulary for the USA guys, who seem to have alot more info on this.

I had a negative endoscopy but severely positive TtG and Iga serology. Are there any other conditions that could cause this blood result?

Thank you for your time.

Kind regards,

Mark

The most likely explanation is that the blood results are correct and you haven't sustained enough damage for the doctor to have found it or they didn't do a good job of getting enough samples when they did the endoscopy. If your Ttg is very high and also the IGA, try the diet and see what dietary response you get. You will most likely see relief and you'll have your answer. If not, then you may have to look at other food intolerances or problems but it sure sounds like celiac disease to me. Good luck!

[ravenwoodglass]

The TTg is pretty specific. Either you are lucky and this was caught before severe villi damage was done or the more likely prospect is that your biopsies either did not hit the right spot in your 22 ft of small intestine or your doctor may not recognize the changes that occur before full villi destruction sets in. I would get on the diet asap.

[happygirl]

Celiac Disease can be a "patchy" disease...i.e., the damage isn't necessarily uniform. So a biopsy might have been taken from a "normal" section.

[Ursa Major]

While false negatives are very common with the bloodwork as well as the biopsy, false positives are practically unheard of with celiac disease. It is very likely that your bloodwork is right, and you do have celiac disease.

Try the diet, and if you respond favourably, you'll have your answer. Many doctors will diagnose celiac disease if you have a combination of positive bloodwork plus relief from symptoms with the diet, even with a negative biopsy. Because a positive biopsy will rule celiac disease in, but a negative one can't rule it out, due to the 'hit and miss' nature of the procedure.

[Matilda]

...

[marklen]

Thank you all so much for your kind feedback, I very much appreciated your thoughtful responses.

Kind regards,

Mark

[Tequila]

Hey Mark,

I had similar results. I got sick this summer. The regular intestinal stuff. Since my mother has celiac I knew what to look for, so after a week of not feeling better, i figured it wasn't just a virus and had my dr order the blood tests. I went off gluten right away, so it was possible I had minimal damage and may not have even built up a very high immune response as it can take a while depending on when the celiac actually started. All the blood tests were positive and my dr said no need for a biopsy. I probably should have had the biopsy done then. 3 or 4 months later I got another set of blood tests and a biopsy( the gi doc said it was possible they might see damage without a gluten challenge, but I don't think they listened to my whole story). Both were negative. The GI docs agreed it was probably celiac and that I just caught it early. Having the blood tests turn around like that after going gluten free is a pretty good indication in and of itself. My reg dr doesn't want me to make myself sick again just to get the positive biopsy. It's understandable that the GI docs want to get the positive biopsy because they want to be absolutely sure that you need a gluten free life since they consider it the end of the world. I have no plans to do the biopsy again since I'm feeling so much better now.

I've read a lot of the literature in medical journals and I have not found a lot of information that suggests anything else. My personal thoughts (and they should not influence anyone to make any medical decisions as I'm not an MD) are that GI docs rarely see someone who has caught celiac so early and therefore had a short immune response and also minimal intestinal damage. Most people I know or have talked to have either not been diagnosed or misdiagnosed for years. So by the time the GI doc sees them and evaluates them their intestines are a mess. It makes it easy for them to diagnose. As people become more aware of celiac it may require the GI docs to think a bit more and consider that people may present differently then they used to. hope that helps.