The “False Positive” Celiac Blood Test: Why Wrong Diagnosis is Possible

It is estimated that celiac disease affects 1 in 100 people in the UK. However, some of these people could actually have been wrongly diagnosed.

A 2016 study found that a considerable number of patients referred to a tertiary care center are inaccurately diagnosed with celiac disease. A recent study found that many of these people are diagnosed without completing the whole diagnostic process. The risk of this causes delay in the evaluation of other diseases and means people may not get the treatment they need.

What is Celiac Disease?

Celiac disease in different to a simple gluten sensitivity. In contrast, if you have gluten sensitivity, your immune system doesn't mount a direct attack against gluten. People with a gluten sensitivity experience a direct reaction to gluten. If you have gluten sensitivity, your body views the protein as an invader and fights with inflammation. This occurs both inside and outside of your digestive tract. With celiac disease, gluten triggers your immune system to attack its own tissues. It is an autoimmune disorder, which makes people with the disease more likely to get other autoimmune disorders.

Symptoms of Celiac Disease          

Celiac disease has similar symptoms to many other conditions, so many people take a blood test for the condition. It can often be confused with gluten sensitivity, causing similar symptoms. This can be dangerous, as Celiac disease is an autoimmune condition.

The Main Symptoms of Celiac Disease are the following:

• Diahrrea and constipation
• Frequent stomach pains
• Bloating
• Unexplained fatigue
• Faecal incontinence
• Weight loss
• Anemia
• Rashes

When Diagnosis Goes Wrong

Getting the diagnosis process right is vital. If those who do not have celiac disease get a false positive result, this can prevent them from getting their required treatment. Although blood test are generally accurate, it is possible to have a false positive result. Symptoms of celiac disease can vary depending on the person, making it difficult to diagnose. Lack of specificity of symptoms can also make it difficult to diagnose. Secondly, the interpretation of the biopsy can also cause confusion. Experts assert that although biopsy is a critical component in the diagnosis of celiac disease, biopsy alone should not be used to diagnose it. MD Carol Semrad asserts, “I question when people tell me someone has “biopsy proven” celiac disease. She questions, “do you mean this patient has a small bowel biopsy that was abnormal, started a gluten-free diet, and then repeat biopsy returned to normal?” Other mistakes include taking an insufficient number of biopsy samples and lack of biopsy orientation. Some Doctors in the past have also determined a positive result based on minimal histopathological findings. Another complication is to diagnose celiac disease based only on the positive responses of patients who have been on a gluten free diet. This improvement alone is not enough evidence to suggest that someone has Celiac disease. As a result, many people with gluten sensitivity or another food allergy can get a false positive. Dr Amy Burkhart insists, “it is important to keep eating a diet containing gluten until the biopsy is done so the results are accurate”.

Common conditions mistaken for celiac disease include:

• Irritable bowel syndrome
• Inflammatory bowel disease
• Lactose intolerance
• Food allergies