Question

A 34-year-old woman presents with chronic diarrhoea, weight loss and iron deficiency anaemia. She has a family history of coeliac disease. Serology shows elevated tissue transglutaminase IgA antibodies. Total IgA level is normal. Which is the most appropriate next step?

Accepted Answer

Arrange small bowel (duodenal) biopsy while she is on a gluten-containing diet

Answer

Start a strict gluten-free diet immediately and no further testing

Answer

Order HLA typing only

Answer

Order colonoscopy only

Answer

Reassure her that serology is non-specific and no further action is needed

Practice question

A 34-year-old woman presents with chronic diarrhoea, weight loss and iron deficiency anaemia. She has a family history of coeliac disease. Serology shows elevated tissue transglutaminase IgA antibodies. Total IgA level is normal. Which is the most appropriate next step?