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Testing


SAVANNAH21

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SAVANNAH21 Apprentice

I recently had a stomach biopsy that showed blunted villi. My family doctor called and said that the pathology report indicated Celiac Disease with blunted villi but he wanted to order some blood work (Celiac Panal). Since his inital phone call to me I have been reading anything and everything possible on Celiac disease. I have just about every symptom that was listed down to the rash that can appear on hand due to too much gluten. I have tried to follow a gluten free diet since my doctor called me 10 days ago. I feel WONDERFUL. No more stomach discomfort, no more nausea,finally my prayers have been answered and I have an answer to why I have been feeling like this for so long..NOW my family doctor calls me today and said, I don't have Celiacs, the blood work was fine. What about the biopsy report, everything I've read indicates that he should go by the pathology report not the blood work. Has this happened to anyone else?


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Salax Contributor

Um, kinda strange if the pathology report says the endo was positive for Celiac Disease, in my humble opinion you have it. That is the "gold standard", I would ask for a copy of both blood and endo pathology reports.

I say 2 out of 3 says you have it-

1. Endo says yes.

2. You fell great on the diet

3. Blood is negative? (according to alot of folks on here, false negatives are very common. this might be the issue.)

Lots of folks here can read your reports if you want to post them to get a couple other opinions. Your doc might be confused, docs seem to not understand jack about testing, positive results or how to eat on the diet. My blood was positive 3 times over and he tells me to go "lite" gluten free. :blink: Um, no. There is no in between, but they don't know the difference.

Glad your feeling better though! :D

Roda Rising Star

Biopsy trumps blood work. Your doctor needs to be aware. If your biopsy is positive you have celiac. Welcome.

SAVANNAH21 Apprentice

Thank you for your comments. Biopsy report states duodenal mucosa with a heavy inflammatory infiltrate consisting of a mixture of lymphocytes and eosinophils. The inflammation involves the glandular eopithelium, broadening and marked flattening of the villi is seen. Epithelium shows increased mitotic activity. Broadening and flattening of the villi is associated with two entities, Non-tropical sprue (celiac disease) and chronic duodenitis. If on a clinical basis, this patient has celiac disease, the microscopic finding are certainly compatible with celiac disease and patient should be treated for the clinical impression.

also of note is that I get dermitis herptiformis on my right hand all the time. I never knew exactly what it was until I read this site. I also recieved a copy of some blood work I had done. ALT is very high and Lipase level is very low. From what I have read on the celiac site this disease and effect your pancreas (lipase) and liver(ALT). My doctor said he's not too concerned with these levels. Am I making a mountain out of a mole hill????

Lisa Mentor

Welcome to the Club! :D

As Roda said, biopsy trumps blood work.

ravenwoodglass Mentor

Thank you for your comments. Biopsy report states duodenal mucosa with a heavy inflammatory infiltrate consisting of a mixture of lymphocytes and eosinophils. The inflammation involves the glandular eopithelium, broadening and marked flattening of the villi is seen. Epithelium shows increased mitotic activity. Broadening and flattening of the villi is associated with two entities, Non-tropical sprue (celiac disease) and chronic duodenitis. If on a clinical basis, this patient has celiac disease, the microscopic finding are certainly compatible with celiac disease and patient should be treated for the clinical impression.

also of note is that I get dermitis herptiformis on my right hand all the time. I never knew exactly what it was until I read this site. I also recieved a copy of some blood work I had done. ALT is very high and Lipase level is very low. From what I have read on the celiac site this disease and effect your pancreas (lipase) and liver(ALT). My doctor said he's not too concerned with these levels. Am I making a mountain out of a mole hill????

If you have DH you have celiac. Go with the biopsy report and get yourself strictly gluten free. You should be feeling much better soon. Do be sure to delete iodine for a while until your skin lesions have been gone for a bit.

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      You really saved me as I was on day 4 of 3 g per day for 6 weeks. Thank you very much!
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      Two weeks is the minimum according to the guideline. I would go for four weeks if you can endure it, just to make sure.
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      Thank you so much! So I can do 10 g worth of gluten in the form of gluten powder per day for two weeks and that should be enough?
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      It applies to both blood tests and biopsies. Guidelines for the gluten challenge have been revised for the very issue your question raises. It was felt by medical professionals that the longer term but less intense consumption of gluten approach was not proving to be reliable for testing purposes and was resulting in too many false negatives. But do keep in mind that the gluten consumption doesn't have to be in the form of bread slices. It can come in any form: pasta, cake, wraps, etc. Another approach would be to buy gluten powder at a health food store and mix it in a shake. The idea is to get at least 10g of gluten daily, whatever form it comes in.
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      Hey there, You mentioned that current guidelines recommend to eat the equivalent of 4-6 slices of wheat bread for several weeks. Is it ok to do less for a longer period of time, for example 2 slices for 6 weeks? Also, does this recommendation apply to blood tests as well as the biopsy, or do they each have different timelines? Thanks in advance!
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