I am new to all of this!! Nice to meet you!

[tex]

Hi Bev,

We have several other members who tested negative to anti-tissue transglutaminase antibodies, but they definitely have MC. Tissue transglutaminase is a human enzyme, found in the cells, and if antibodies to this enzyme are found in the blood, (or the stool), their presence indicates an autoimmune reaction, (a reaction against self - one's own body). People who are deficient in immunoglobulin A, (IgA), cannot produce those antibodies, or at least cannot produce normal amounts. Therefore a tissue transglutaminase test can produce a false negative result, for them. We have at least a couple of members who are IgA deficient, who have MC. IgA deficiency is determined by a specific test procedure.

None of this has anything to do with the diagnosis of lymphocytic colitis. LC is diagnosed by examining slides of biopsy samples taken from the colon, and counting the number of lymphocytes which are infiltrated into the outer epithelium layer, (the mucosa). A slide from a "normal", (un-diseased), colon, will have roughly 15 to 20 lymphocytes per 100 epithelial cells, when viewed under the microscope. If more than 15 or 20 lymphocytes are present, (per 100 epithelial cells), then the indication is LC, (assuming that crypt architecture is preserved). Collagenous colitis is further characterized by a collagen band at least 10 μm, (micrometers), thick, in the sub-epithelial layer. When both markers are present, most pathologists simply refer to the disease as MC. Note that "crypt architecture" refers to the physical characteristics of the surface of the epithelial cells, and as I noted above, that should appear normal, with MC. If lesions are present, so that the crypt architecture is abnormal, then some other disease is indicated, (such as Crohn's, or ulcerative colitis, etc.).

The slides are virtually always analyzed by a pathologist, and the pathologist actually makes the diagnosis. We have seen cases, though, where a pathologist made a diagnosis of MC, but the GI doc "ignored" the pathologist's report, and told the patient that "everything was normal". That doesn't happen much anymore, though, now that GI docs are slowly learning more about MC.

The bottom line is, it is extremely difficult for a pathologist, who is worth his or her salt, to misdiagnose MC, because even you or I could do it, if we had the slides, and the microscope, and a basic knowledge of what we were looking for. IOW, it's not rocket science, so the odds are extremely high that your diagnosis of LC is correct.

Tex

[Helovesme]

Thanks..I was starting to worry....My gastro is Dr. Scott Lewey...he did the scopes...and his nurse followed up with me. I know he is very particular about the pathology. Anyway, I am so thankful I finally have an answer. I was convinced I was just gluten intolerant...and was praying I had celiac and not cancer....I really think gluten is not good for anyone. My whole family is now gluten free...my husband is thrilled is no longer bloated I am so tired today, I think I am not eating enough protein. I have not eaten red meat in 25 years...and I have to make myself eat turkey and chicken. Tex...thanks so much for your quick answers...you are a blessing.

[tex]

Bev,

Wow! Congratulations! You have one of the most capable GI docs on the North American continent, for diagnosing and treating MC. Trust me, he knows what he's doing, and you are in very good hands. We have one other member from Colorado who is a patient of Dr. Lewey. (He won't accept patients from out of state, unfortunately. )

You're most welcome,
Tex