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October 26, 2006

Celiac

Question from East Dumbartonshire, Scotland:

I am a young teenager with diabetes and may have coeliac disease. For many years now, I have tested positive for coeliac antibodies, yet, the last time I had a biopsy, I tested negative. Why is this? Will I definitely get it? Is there anyway possible to prevent this?

Answer:

You ask a difficult question. Depending upon the exact blood antibody test that your doctors did, there are sometimes false positives. The biopsy usually proves this either way. There is some discussion if the biopsy is more accurate or the blood tests are more accurate, but it is not 100% clear. Also, if the antibody tests were only weakly positive, you could have a wheat/gluten allergy that causes the antibody tests to look abnormal, but this is different than true celiac disease. Sometimes, there are also other allergy abnormalities – eye and nose allergies, eczema, asthma, for instances and these respond to avoiding wheat and gluten even when there is no celiac disease. The only way to know for sure would be to avoid wheat and gluten completely and see if the blood antibody tests get better after 12 months, see if any symptoms go away or if you actually feel better. We have many patients who have done this, feel better and do not have celiac disease, but avoid wheat and gluten because they feel better. So, go back and discuss this with your diabetes team so that they can help you sort out what to do, if anything.

SB