Positive Ttg, Normal Biopsy- What Does This Mean?

[ladhowar]

I have been "diagnosed" with Celiac Disease, but I was hoping I could get some input regarding the accuracy of the serolgy test (Tissue Transglutaminase Ab, IGA) in confirming a celiac disease diagnosis. I have read that the "gold standard" is a positive antibody test along with an intestinal or small bowel biopsy; however, things didn't play out so perfectly for me. See below for my test results:

Procedure: Tissue Transglutaminase Ab, IgA

My results: 7.3 AU

Reference Intervals: Negative <7.0 AU, Positive >=7.0 AU

Procedure: Endomysial Ab IgA Ser Ttr

My results: None Detected

Procedure: Intestinal Biopsy

My results: No evidence of Celiac Sprue

I have read that the TtG test is very sensitive and specific to Celiac, but I wasn't sure how reliable it was when the biopsy comes back as normal. In a separate post, I noticed a comment about the TtG test and how it is a measure of how much damage has actually been done to the villi. I'm thinking since my TtG is only a 7.3, then that could be why my biopsy came back "normal." Also, is it possible that the biopsied areas just happended to be areas that have yet to be affected? I had a series of other blood tests done before these which would have ruled other diagnoses such as Type I Diabetes. Any input would be greatly appreciated!

THANKS in advance!!

[Guest j_mommy]

Somtimes they don't take enough samples.

Have you went gluten-free already?(Before the biopsy)

[ladhowar]

Somtimes they don't take enough samples.

Have you went gluten-free already?(Before the biopsy)

I had not started the gluten-free diet before the biopsy. I did not start until December 26th. I went back to the doctor today to discuss the results of the biopsy and even though it was normal, she was still fairly confident of a celiac disease diagnosis and wanted me to continue on the gluten-free diet. She said we would test the antibodies again in a few months to check for improvement.

She is a good doctor and I would hate to second guess her judgement as she was able to figure this out in just 2 visits! I had gone to another doctor for 5 years with that same symptoms over and over again. I think she had me pinned as a hypochondriac and never did a single diagnostic test. I know I have a good doctor now, but I just hate that there is no cut and dry way of figuring this out. Any thoughts?

[ravenwoodglass]

I had not started the gluten-free diet before the biopsy. I did not start until December 26th. I went back to the doctor today to discuss the results of the biopsy and even though it was normal, she was still fairly confident of a celiac disease diagnosis and wanted me to continue on the gluten-free diet. She said we would test the antibodies again in a few months to check for improvement.

She is a good doctor and I would hate to second guess her judgement as she was able to figure this out in just 2 visits! I had gone to another doctor for 5 years with that same symptoms over and over again. I think she had me pinned as a hypochondriac and never did a single diagnostic test. I know I have a good doctor now, but I just hate that there is no cut and dry way of figuring this out. Any thoughts?

You have a good doctor who doesn't want to see you half dead before diagnosing you. I hope you listen to her. I would continue with the diet as she has requested you do.

[GlutenWrangler]

You have a great doctor. I definitely wouldn't second guess her advice to go on a gluten-free diet. You don't need a positive biopsy at this point. I really wouldn't worry about it if I were you. Just stay gluten-free and let yourself feel better. When the doctor re-tests you, your Ttg levels should drop. Take care,

-Brian