Clan Thompson's Celiac Site

Q & A

QUESTION: I have enjoyed reading about you in various emails on the celiac list serve. Your responses in the Clan Thompson Celiac Newsletter are helpful...I was tested for celiac via a blood test after going back on gluten for two weeks and the IgG was (49) Positive and the IgA was Negative. After four more weeks of eating gluten we did the biopsy which came back negative. I was so miserable eating wheat again for that period of time I now continue to be gluten and dairy free even though the biopsy came back negative. I feel so much better that I continue to wonder if I still could be Celiac with the negative "Gold Standard Biopsy". Is there still any chance of this?

DR. RUDERT: Thank you for your kind words. IgA deficiency is increased in Celiac Disease. When I order Celiac antibodies I also always obtain serum for IgA. Since many of the blood tests are IgA antibodies, if one has Celiac Disease and is IgA deficient their blood tests may be "normal", therefore, representing a false negative. Of course, this would not pertain to antigliadin IgG.

Regarding your specific question, I sometimes disagree with biopsies that come back "negative" or normal. Early Celiac Disease is sometimes difficult to diagnose. Secondly, I would hope that you had multiple biopsies performed from appropriate locations in the small intestine. In other words, if you just had one specimen taken during the procedure this could represent a sampling error.

Regardless, you appear to be obviously symptomatic when eating wheat. Therefore, if we assume the biopsies are correct and this does not represent sampling error, I would label you as being severely gluten intolerant versus latent Celiac Disease. Latent Celiac Disease can progress to Celiac Disease with continued gluten ingestion.

I would strongly encourage you to remain gluten free and in view of your symptoms, you probably don't need much encouragement.

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