Categorized: Celiac Disease Diagnosis

My blood tests came back negative, but I’d only been eating gluten for about a month. I also had an endoscopic biopsy after three months of eating gluten where they found patchy infiltration with lymphocytes. My doctor doesn’t want to diagnose me with celiac disease because the blood tests were negative. Should I seek a second opinion?

If you had been gluten-free for a long time and only ate gluten for one month prior to your blood work then it may not have been accurate. In other words, you probably have celiac disease. Consider having another endoscopic biopsy after one year on a strict gluten-free diet to see if complete healing of… Read more »

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Why do 20% of healthy people make antibodies against gliadin?

Probably because they’ve had a somewhat increased intestinal permeability at a time when they ate gluten, (e.g., during a stomach flu) and the gut immune system has reacted by producing anti-food protein antibodies. Their presence simply indicates that gluten was ingested, and otherwise has no general clinical meaning.

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Are biopsies of the small intestine conclusive?

Generally, antibody blood tests and biopsies are sensitive and specific enough to clearly diagnosis celiac disease. However, because no test is perfect, a firm diagnosis should include antibody blood screening, biopsies and response to a gluten-free diet. Although biopsies are the standard for diagnosis, periodically they do not lead to a clear diagnosis. Many factors… Read more »

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What is a gluten challenge?

A gluten challenge is the period of time when gluten is added back into a person’s diet to assist in the diagnosis of celiac disease. Antibodies take time to build into the blood stream before they can be detected through blood analysis. For a gluten challenge we recommend eating 1/2 slice of bread or a… Read more »

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How common is IgA deficiency in those with celiac disease?

2-5% of those with celiac disease are IgA-deficient, and 0.5-1% of the general population. If IgA deficient, or if there is some other equivocating factor to potentially compromise the blood test, then an EMA blood test is also given.

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Which blood tests should I have to screen for celiac disease?

You should have both tTG-IgA and total serum IgA tests to screen for celiac disease. As long as you produce IgA (total serum IgA confirms you do), tTG-IgA is 98% accurate in measuring elevated antibodies. If you are IgA deficient, or if there is some other equivocating factor to potentially compromise the blood test, then… Read more »

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What can I do about IgA deficiency?

You can’t do anything about IgA deficiency. However, it also doesn’t lead to any clinical issues. If you are attempting to get an accurate diagnosis for celiac disease and you know you’re IgA deficient, or if there is some other equivocating factor to potentially compromise the blood test, then an EMA blood test should also… Read more »

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