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A member asked:
Celiac antibodies positive (ttg and ema) but biopsy was negative (10 samples taken).been gf 7 months and not feeling any better.ttg rechecked for gluten exposure but negative.i lost weight and alt was elevated.do you think i have celiac?
A doctor has provided 1 answer
The discordant serology/ small bowel biopsy is difficult to interpret and many times the pathology slides are evaluated by a second pathologist. Genotyping is used sometimes looking for HLA DQ2/DQ8 that if negative rules out celiac disease. Finally a repeat biopsy following a few weeks challenge with a gluten rich diet may result in positive biopsies that would confirm the diagnosis.
Answered 4/7/2021
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