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Help Interrpreting Labs


Patrician

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Patrician Newbie

Sorry, you guys probably get this all the time. I have been gastro sick (extreme abdominal pain and diahrea) off and on for 20+ years. I have had two biopsies-one ten years ago and one 8 months ago-both showed mild gastritis, but no damaged villi. I have gone to several different GI doctors, none of which are helpful. I received the following labs 3 months ago:

Deamidated Gliadin ABs, Iga-Negative

Deamidated Gliadin Abs, IgG-Negative

t-Transglutaminase (tTG) IgA-Negative

T-Transglutaminase (tTG) IgG-Very positive

Endomysial Antibody IgA-Negative

Immunoglobulin A, Qn, Serum-Negative

Is this enough to indicate Celiac Disease? Can something else cause the one positive result? I have discussed the results with three different doctors, one GI and two family type doctors, and have been told three different things. I went off gluten three months ago, I feel minutely better, but not much. Any help would be greatly appreciated.


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Skylark Collaborator

TTG antibodies can show up in Crohn's and microscopic colitis as well as celiac. Anti-DGP can be negative. Have your doctors ruled those out?

Some people require a super-strict diet to recover from celiac. If there is still gluten in your kitchen, you're eating a lot of processed foods, or you're eating out a lot you may be getting too much gluten to heal. eating gluten even occasionally will also keep you from feeling better. There is no room in the diet for an occasional cookie or cracker. Also intolerance to dairy and soy can really slow down healing. Other people with a lot of bowel trouble don't tolerate grains well.

There is an old diet called the Specific Carbohydrate Diet that was designed for people with chronic GI problems back in the '30s and '40s when IBS, celiac, Crohn's, and so forth were all lumped together. It worked for a LOT of people. The SCD is still around, plus there is a new and improved version called GAPS. I'd strongly suggest you have a look at GAPS and see if it looks like something that might help you. Open Original Shared Link and Open Original Shared Link are the websites for the two diets.

Patrician Newbie

The GI doctor said that I didn't have Crohn's, but did not indicate how she new. I asked her if there was anything else besides Celiac that causes high tTg (IgG) and she said 'no'. I do not know how reliable she is and I have no idea where to go from here. I did stop eating gluten, but don't feel much better. I haven't cheated at all, to my knowledge. I Have a full time job plus four children. I could be getting some from cross contamination, but I have tried to be really careful. It's only been a few months and I understand that it can take time, since I have been sick on and off since my teens (I am in my forties now).

  • 2 weeks later...
MissKris2 Newbie

The same thing happened to me, Patrician. I had a very positive tTg- IgG. The doctor said I don't have celiac. I asked what could cause the high tTg-IgG and she said that it is associated with celiac. I asked if anything else could cause it since she had just told me I don't have celiac. She said that she had to look into it and would let me know and I never heard from her.

nora-n Rookie

maybe it only shows on the number of IEL´s on each villi tip:

Open Original Shared Link

here it says that more than 4 IEL´s on a villi tip is abnormal.

The fins have researched positive ttg and negative biopsies, and the conclusion is that this is celiac too.

Patrician Newbie

I looked through all the lab resuts. It does not mention IELs anywhere. Just "enteric mucosa with intact villi". Frustrating. I have an appointment tomorrow, I will ask, but I doubt she will know anything. I am going to ask for another celiac panel blood test. I have been off gluten for 3 months, if the IgG levels are down, I most likely have my answer. Thanks to those who responded.

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    • trents
      NCGS does not cause damage to the small bowel villi so, if indeed you were not skimping on gluten when you had the antibody blood testing done, it is likely you have celiac disease.
    • Scott Adams
      I will assume you did the gluten challenge properly and were eating a lot of gluten daily for 6-8 weeks before your test, but if not, that could be the issue. You can still have celiac disease with negative blood test results, although it's not as common:  Clinical and genetic profile of patients with seronegative coeliac disease: the natural history and response to gluten-free diet: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5606118/  Seronegative Celiac Disease - A Challenging Case: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9441776/  Enteropathies with villous atrophy but negative coeliac serology in adults: current issues: https://pubmed.ncbi.nlm.nih.gov/34764141/  Approximately 10x more people have non-celiac gluten sensitivity than have celiac disease, but there isn’t yet a test for NCGS. If your symptoms go away on a gluten-free diet it would likely signal NCGS.
    • Xravith
      I'm very confused... My blood test came out negative, I checked all antibodies. I suppose my Total IgA levels are normal (132 mg/dl), so the test should be reliable. Still, I'm not relieved as I can't tolerate even a single biscuit. I need to talk to my doctor about whether a duodenal biopsy is necessary. But it is really possible to have intestinal damage despite having a seronegative results? I have really strong symptoms, and I don't want to keep skipping university lectures or being bedridden at home.
    • Scott Adams
      They may want to also eliminate other possible causes for your symptoms/issues and are doing additional tests.  Here is info about blood tests for celiac disease--if positive an endoscopy where biopsies of your intestinal villi are taken to confirm is the typical follow up.    
    • Scott Adams
      In the Europe the new protocol for making a celiac disease diagnosis in children is if their tTg-IgA (tissue transglutaminase IgA) levels are 10 times or above the positive level for celiac disease--and you are above that level. According to the latest research, if the blood test results are at certain high levels that range between 5-10 times the reference range for a positive celiac disease diagnosis, it may not be necessary to confirm the results using an endoscopy/biopsy: Blood Test Alone Can Diagnose Celiac Disease in Most Children and Adults TGA-IgA at or Above Five Times Normal Limit in Kids Indicates Celiac Disease in Nearly All Cases No More Biopsies to Diagnose Celiac Disease in Children! May I ask why you've had so many past tTg-IgA tests done, and many of them seem to have been done 3 times during short time intervals?    
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