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Ema Test?


kpyoung24

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kpyoung24 Rookie

Hi everyone! im new here..... after taking my 7 year old daughter to her pcp with gi symptoms the doc ran two celiac disease tests.. the gliadin and the endomysial(ema) tests. they called two days later with results saying that both tests came back "elevated" and that she probably has celiac but that the diagnosis needs to be confirmed by a gi specialist. i spoke with the gi nurse and she said that the EMA test is pretty specific to celiac disease and that's most likely the diagnosis we are facing but that the gi doc will decide to run the transglutiminase (or however its spelled, lol) test or proceed with the biopsy based on the lab work that the pcp ordered. i guess what im looking for is any info anyone can give me as to whether or not the EMA test is pretty definitive, and if the biopsy is necessary. i know there are many different opinions on this, anything would be appreciated! thanks!!!! kimberly


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GlutenWrangler Contributor

Kimberly,

The Endomysial Antibody test is very specific for Celiac Disease. Your son's blood test results are conclusive for Celiac Disease. A biopsy is not necessary if you don't want to put your son through it. Some gastroenterologists would just diagnose your son with Celiac Disease with just those test results, and not even bother with a biopsy. A biopsy is useful if you want to determine the level of villi destruction, but it's definitely not necessary at this point for a diagnosis. Hope this helps.

-Brian

kpyoung24 Rookie
Kimberly,

The Endomysial Antibody test is very specific for Celiac Disease. Your son's blood test results are conclusive for Celiac Disease. A biopsy is not necessary if you don't want to put your son through it. Some gastroenterologists would just diagnose your son with Celiac Disease with just those test results, and not even bother with a biopsy. A biopsy is useful if you want to determine the level of villi destruction, but it's definitely not necessary at this point for a diagnosis. Hope this helps.

-Brian

hi brian! thank you very much for your reply! it helps a lot! another question i have is about the biopsy. the tests that were run on my daughter included what the doc referred to as the basic stuff, which she said was like thyroid, elektrolytes etc.... these tests were all "normal", does this indicate that she has little or no villi damage thus far? if so doesn't that make the biopsy completely unnecessary??~K

happygirl Collaborator

The rest of your bloodwork can be fine and your villi can be completely flattened.

The other purpose of an endoscopy is to look for other problems that are causing symptoms.

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    • par18
      Thanks for the reply. 
    • Scott Adams
      What you’re describing is actually very common, and unfortunately the timing of the biopsy likely explains the confusion. Yes, it is absolutely possible for the small intestine to heal enough in three months on a strict gluten-free diet to produce a normal or near-normal biopsy, especially when damage was mild to begin with. In contrast, celiac antibodies can stay elevated for many months or even years after gluten removal, so persistently high antibody levels alongside the celiac genes and clear nutrient deficiencies strongly point to celiac disease, even if you don’t feel symptoms. Many people with celiac are asymptomatic but still develop iron and vitamin deficiencies and silent intestinal damage. The lack of immediate symptoms makes it harder emotionally, but it doesn’t mean gluten isn’t harming you. Most specialists would consider this a case of celiac disease with a false-negative biopsy due to early healing rather than “something else,” and staying consistently gluten-free is what protects you long-term—even when your body doesn’t protest right away.
    • Scott Adams
      Yes, I meant if you had celiac disease but went gluten-free before screening, your results would end up false-negative. As @trents mentioned, this can also happen when a total IGA test isn't done.
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