Explain Positive Biopsy In English :)

[Mom-of-Two]

I already knew I was celiac based on hugely positive blood panel, I had the biopsy done and the nurse gave me results over the phone basically saying that yes, my gut says I have celiac. (not a surprise)

I finally got the actual copy of the report in the mail, and thought someone could interpret. Just curious!

Diagnosis:

Duodenum, biopsy -- variable villous abnormality with marked intraepithelial lymphocytosis.

The pattern of injury is highly suggestive of a gluten sensitive enteropathy, correlation with serologic data is required to confim diagnosis.

I have not heard of that before, the intraepithelial lymphocytosis, is this just damage, or something particular, less damage, more damage?

[Skylark]

The "intraepithelial lymphocytosis" means that there are a lot of white blood cells (lymphocytes) in your biopsy. There are not normally a lot of lymphocytes in the mucosa, just a few here and there to deal with food-borne bacteria. The autoimmune antibodies in celiac disease signal large numbers of a particular type of lymphocyte called natural killer cells to come to your intestines. These cells usually kill invading bacteria and viruses; in celiac disease they get confused and instead kill your villi.

The intraepithelial lymphocytosis happens in everyone with celiac disease. It precedes the damage and doctors are starting to consider it an early indicator of celiac. The villous abnormality they mention in your biopsy is the start of the autoimmune damage. It sounds like you're not in too bad shape. The diet should sort things right out.

[Mom-of-Two]

Great, thanks!!

That would explain why I do not have vitamin and nutrient deficiencies perhaps. I have had the stomach bloating and cramps for 2-3 years. I had what I thought was lactose/milk issues as a teen and young adult, when I found out I had celiac I thought perhaps those were my symptoms all along, but I'm 32 so I would have pretty severe damage by now if I had active celiac all my lfe! My GI dr, and myself, believe this was likely brought on by the abdominal surgery and sepsis I had 5 years ago, with 2 months of strong antibiotics that damged my gut as well.

That info was helful.