Jump to content
This site uses cookies. Continued use is acceptance of our Terms of Use and Privacy Policy. More Info... ×
  • Welcome to Celiac.com!

    You have found your celiac tribe! Join us and ask questions in our forum, share your story, and connect with others.




  • Celiac.com Sponsor (A1):



    Celiac.com Sponsor (A1-M):


  • Get Celiac.com Updates:
    Support Our Content
    eNewsletter
    Donate

New & Need Help Interpreting Biopsy Results


Carrie923

Recommended Posts

Carrie923 Newbie

I have been having RQ abdominal pain for over 2 months now. Ultrasounds & CT show everything is clear. Had an upper/lower scope last week and the results are posted so I can see them now but my Dr's appointment isn't for 2 more weeks. I'm confused about the results for the celiac biopsy and hoping to get help here to understand it better.

---Pathologic Diagnosis---

Endoscopic biopsies -

A - Duodenum - celiac:

Duodenal mucosa with normal villous architecture and increased

intraepithelial lymphocytes (SEE NOTE).

NOTE: The morphological findings are etiologically nonspecific and have

been described in patients with latent celiac disease, bacterial

overgrowth, viral gastroenteritis, in association with NSAID use or H.

pylori gastritis, tropical sprue, immunodeficiency syndromes, and more

recently also as a manifestation of duodenal involvement in Crohn's

disease. Clinical and serological correlation is recommended.

B - Gastric - h. pylori:

Gastric antral and fundic gland mucosa with nonspecific reactive

gastropathy. No H. pylori-like microorganism is seen.

C - GE junction 45 - Barrett's:

Squamocolumnar junctional mucosa (cardia type) with chronic nonspecific

inflammation. There is no evidence of intestinal metaplasia.

D - TI - Crohn's:

Ileal mucosa with reactive appearing lymphoid aggregates, consistent

with Peyer's patches.

E - Random colon - microscopic colitis:

Colonic mucosa within normal limits.

Also - what is <4.0 for TTG IgA? Seems mostly negative right?

Your Value Standard Range Units

<4.0 <=3.9 u/ml


Celiac.com Sponsor (A8):
Celiac.com Sponsor (A8):



Celiac.com Sponsor (A8-M):



mommyto2kids Collaborator

My Dr. called me right away about my results. Can you call and have them at least tell you if you have celiac disease? Gosh I'd try that.

jeanzdyn Apprentice

My gastroenterologist told me "we think that maybe you have celiac disease". How is that for a definitive answer!

The only thing is that I was not surprised to hear this diagnosis. A couple of years prior to the colonscopy I tried avoiding bread and pasta on a 3-day rotational basis. That is to say that I did not eat any bread or pasta for 3 days in a row and then, on the 4th day I would eat whatever I wanted to eat. I did this to alleviate severe itching --(just itching, no blisters, scabs, or inflammation was apparent at all). It relieved the itching, but it did make me start thinking about what the cause of the itching could be.

So, when the nurse said 'sprue' and the doctor said "maybe celiac disease" I was almost relieved.

Being gluten free has relieved a great number of my symptoms, so I am going with that --I have celiac disease -no maybe about it.

Pin the doctor down and make him/her explain the test results!

IrishHeart Veteran

I would call the doctor's office.

Why did they release the pathology report to you without interpretation? Ridiculous.

There are 3 things that I see here (but I am not a doctor, so I cannot tell you what they mean exactly)

(1) You have normal villous architecture (meaning no blunting) (but this is also consistent with LATENT celiac disease)

and

(2) "Crohn's: Ileal mucosa with reactive appearing lymphoid aggregates, consistent with Peyer's patches"

"Peyer's patches play a major role in intestinal immunity, are portals of entry for significant pathogens, and may be important in Crohn's disease."

Note the research says "may be" and "consistent with". Not that it means that is what you have.

and

(3)

"increased intraepithelial lymphocytes" (According to what I have read, it is not uncommon to find a raised intraepithelial lymphocyte (IEL) count with normal villous architecture in the duodenum.)

...which have been described in patients with latent celiac disease, bacterial overgrowth, viral gastroenteritis, in association with NSAID use or H.pylori gastritis, tropical sprue, immunodeficiency syndromes, and more

recently also as a manifestation of duodenal involvement in Crohn's disease.

and Clinical and serological correlation is recommended.

Meaning, they will look at all your symptoms, health history and your blood work to see what correlates with these pathology findings.

(H. Pylori, Barrett's esophagus and microscopic colitis seem to be ruled out in this report.)

To me, this means you COULD have latent celiac disease, an infection or Crohn's

or all or none of them. I have no idea of your history nor would I even begin to speculate further.

Call the doctor before you drive yourself crazy wondering what it means.

Carrie923 Newbie

Thank you IrishHeart. I got my follow up moved from 6/22 to 6/11 so I'm excited about that. In agony right now so really hoping for some answers.

ravenwoodglass Mentor

Thank you IrishHeart. I got my follow up moved from 6/22 to 6/11 so I'm excited about that. In agony right now so really hoping for some answers.

You have had the blood work and the biopsy there is no reason for you to continue in agony. Go ahead and start a trial of the diet, strictly. You may get a bit of relief before you even go back for the followup.

IrishHeart Veteran

I agree with Raven.!!!

I would start my gluten free life and healing process right now. :)

Your celiac testing is done.


Celiac.com Sponsor (A8):
Celiac.com Sponsor (A8):



Celiac.com Sponsor (A8-M):



Carrie923 Newbie

I guess I've been waiting for a definite yes or no that this is celiac or chron's related.

I'm still at the overwhelmed stage of thinking about a celiac diet. I need to read up more on how to really make the switch. I had a fruit shake for breakfast and will do a salad for lunch but am afraid I'm not up on the hidden glutens.

Do you guys understand that TTG IgA result I posted above? I have no idea what the <4.0 means.

IrishHeart Veteran

I guess I've been waiting for a definite yes or no that this is celiac or chron's related.

I'm still at the overwhelmed stage of thinking about a celiac diet. I need to read up more on how to really make the switch. I had a fruit shake for breakfast and will do a salad for lunch but am afraid I'm not up on the hidden glutens.

Do you guys understand that TTG IgA result I posted above? I have no idea what the <4.0 means.

?? No clue, sorry. It is not a full celiac panel report.

No worries about adapting to the gluten-free life.

You are in the right place to learn! We'll help.

Most people start with a whole foods diet, but incorporate Certified gluten-free foods into their diets. Make sure you get enough protein. Many people also dump dairy at first.

Start reading about celiac and the diet here:

Keep us posted after your doctor visit.

MitziG Enthusiast

Ttg is just one blood test for celiac out of the 5 or 6 that they SHOULD do. Your ttg was negative. Your biopsy is somewhat inconclusive. You have some indications of celiac or chrons- but nothing definitive.

Definitely try going gluten-free now. You have nothing to lose and it isn't as hard as you think. Start eating whole foods only- no processed stuff. If your symptoms abate you have your answer and you can be thrilled that you caught it before your intestines were completely ravaged!

Carrie923 Newbie

Thanks!! What are the names of the other blood tests?

IrishHeart Veteran

There is no standardization in current tests. A number of tests, sometimes collectively referred to as the Celiac Blood Panel or Cascade, will aid in diagnosis. The tests may include, but are not limited to:

Serologic Tests

EMA (Immunoglobulin A anti-endomysium antibodies)

AGA (IgA anti-gliadin antibodies) Some people do not produce IgA antibodies.

DGP (Deamidated gliadin peptide antibody)

tTGA (IgA anti-tissue transglutaminase)

Deamidated gliadin peptide (DGP) antibodies tests developed in 2007 in combination with Tissue transglutaminase (TTG) antibodies and have better accuracy than native gliadin antibodies.

And some people, like me, test NEGATIVE but are celiacs nonetheless.

Archived

This topic is now archived and is closed to further replies.


  • Celiac.com Sponsor (A19):



  • Member Statistics

    • Total Members
      129,817
    • Most Online (within 30 mins)
      7,748

    GFDF23
    Newest Member
    GFDF23
    Joined

  • Celiac.com Sponsor (A20):


  • Forum Statistics

    • Total Topics
      121.2k
    • Total Posts
      1m

  • Celiac.com Sponsor (A22):





  • Celiac.com Sponsor (A21):



  • Upcoming Events

  • Posts

    • badastronaut
      hmm, I only had a colonoscopy. Would be interesting to have an endoscopy done then I guess.
    • Beverage
      You said the colonoscopy showed no damage. Did you also have an endoscopy? The upper colon is where celiac damage would be detected via endoscopy, not the colon.
    • trents
      Welcome to the  forum @maylynn! Have you had a follow-up endoscopy/biopsy of the small bowel to check for healing of the villous lining? If not, it's about time one was done. As Scott mentioned, I also wonder if you have food intolerances in addition to gluten. Oats (even gluten free oats), dairy, soy, corn and eggs are some of the most common ones in the celiac community.
    • Scott Adams
      Is your gluten-free diet strict? Do you eat out in restaurants? If so, you could be getting contamination, and over time that can slow recovery. You may want to get a follow up celiac disease antibody panel done to make sure that your levels have gone down since your last tests. Also, have you had various nutrient levels checked via a blood test, and have you been taking vitamin & mineral supplements since your diagnosis?  The most common nutrient deficiencies associated with celiac disease that may lead to testing for the condition include iron, vitamin D, folate (vitamin B9), vitamin B12, calcium, zinc, and magnesium.    Do you still have celiac disease symptoms?  Many people with celiac disease, especially those who are in the 0-2 year range of their recovery, have additional food intolerance issues which could be temporary. To figure this out you may need to keep a food diary and do an elimination diet over a few months. Some common food intolerance issues are dairy/casein, eggs, corn, oats, and soy. The good news is that after your gut heals (for most people who are 100% gluten-free this will take several months to two years) you may be able to slowly add some these items back into your diet after the damaged villi heal. This article may be helpful:    
    • maylynn
      Hello!  I am here as a last result, hoping for some advice, similar stories, etc. When I was 17, I was diagnosed with Celiac disease. By the time we figured it out my iron levels were so low I had to get infusions, and I had lost 20lbs. in two weeks going from a 5'11 130lbs woman to a 110 lbs. Now, I am 21 and have gained 4 lbs since. Every time I eat a meal, I get three bites in and feel so full that I feel sick. I can't eat a full meal. Something else has to be wrong right? This can't just be more "normal" right? I have done test after test and no doctor in my area can figure anything else out. They have told me I most likely have shrunken my stomach by now with how little I am eating so that has to do with some of the sick feeling. What have you done to gain the weight back? Foods? Workouts? 
×
×
  • Create New...