<<Disclaimer: Verify this information before applying it to your situation.>>
Thank you to everyone who responded. I hope this summarizes well enough for those of you who asked for a summary.
Would you say that Celiac Disease is present solely because of the flattened villi? Or could there be another cause to the flattened villi?
1) Biopsy is the "Gold Standard". The best proof of celiac disease.
2) According to a 2002 medical paper by Abdulkarim & Murray here are the other diseases where the villi damage can look like celiac.
cow's milk intolerance
tropical sprue
radiation damage
recent chemotherapy
gravt-vs-host disease
chronic ischaemia
giardiasis
Chron's disease
autoimmune enteropathy
enteropathy-associated T-cell lymphoma
combined immunodeficiency states
gastroenteritis
eosinophilic gastroenteritis
severe malnutrition
Zollinger-Ellison syndrome
refractory sprue
collagenous colitis
3) Did your doctor test your circulating IgA level? In some celiacs it is quite low and there is not enough circulating IgA to react in the three other tests. Therefore the negative test results are invalid. If this is the case, only the IgG will be positive.This may have been so in your case. You can check with your doctor to see if he did this.
4) Some people think it is possible to get the flattened villi from
other IgA allergens, but that wouldn't account for why
you feel better now. A more plausible explanation is
that the IgA didn't escape from the gut enough to make
the blood test positive ... which is good, it means your
intestines are in pretty good shape. Or, you have a general
shortage in IgA (a lot of people do, which is why they test
for IgG).
5) From my own experience, I've heard that the biopsy is the definitive test for CD and the blood antibodies are not definitive either way. My gliadin was only slightly elevated, but I had almost not villi.
6) I think I heard one time that a virus could cause flattened villi. I
don't know this for sure but it may be something you would want to ask your dr or research on the internet.
7) The gold standard *is* the biopsy. So yes you have CD.
Many people are only positive on one or two tests and then get positive biopsies. In fact there are a very few people that have all negative blood work, but are found to have CD. Did your doctor do the Total IgA blood test. If not, you should have it done. If your Total IgA is low, you are IgA deficient and would not be likely to get positive results on the EMA or the IgA test.
Your blood work now is important for follow-up exams - every year. Since you were positive on the IgG test, you should have that test re-done every year. It's used to see if you are truly eliminating all of the gluten from your diet. If you are totally GF, the results on that test should fall into the normal range. I don't know how long that takes though.
8)
if you have a selective IgA deficiency your tests would have come back that way.http://cdli.asm.org/cgi/content/full/7/2/192?view=full&pmid=10702491the following paper covers a lot of ground, and notes:Although villous atrophy is not specific to celiac disease, only a few other diseases associated with villous atrophy occur in developed countries, especially in adults. Graft versus host disease, radiation treatment, and ischemia are readily differentiated by patient history or other tests. Tropical sprue is a consideration in persons who have traveled to or lived in tropical areas. These patients should be treated for tropical sprue and discouraged from avoiding gluten. A failure to respond to the appropriate therapy for tropical sprue should suggest the possibility of celiac disease. Serologic tests may help to distinguish the 2, but few cases of tropical sprue have been included in the validation studies of serologic testing. Intestinal lymphangiectasia, Whipple
disease, and amyloidosis are readily differentiated by the histologic appearance of the intestine. Immune deficiency states that may coexist with celiac disease can usually be identified by electrophoresis or HIV testing. Giardiasis rarely produces such severe damage as that seen in celiac disease except in immunodeficiency states. In very young children, cow milk, soy, and rare other foods may induce villous atrophy similar to that in celiac disease, although the damage is usually not as severe. Crohn disease of the duodenum is rare but may mimic celiac disease and occasionally the 2 diseases coexist (81).http://www.ajcn.org/cgi/content/full/69/3/354?
Best of luck to all, GF is the way to be.
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