Question

A 30-year-old man presents with chronic diarrhoea and fatigue. Serology shows positive IgA anti-TTG antibodies, but total IgA is undetectable. What is the most appropriate next step in investigation?

Accepted Answer

Test for IgG anti-TTG or IgG Endomysial antibodies (EMA)

Answer

Proceed directly to duodenal biopsy

Answer

HLA-DQ2/DQ8 genotyping

Answer

Start gluten-free diet and monitor response

Answer

Repeat IgA anti-TTG in 6 months

Practice question

A 30-year-old man presents with chronic diarrhoea and fatigue. Serology shows positive IgA anti-TTG antibodies, but total IgA is undetectable. What is the most appropriate next step in investigation?