Question

A 28-year-old woman presents with chronic fatigue and intermittent watery diarrhoea. She has lost 6 kg over 6 months. Examination reveals mild pallor and a BMI of 18 kg/m². Her tissue transglutaminase IgA antibodies are strongly positive. What is the most appropriate next step?

Accepted Answer

Confirm coeliac disease with duodenal biopsy while on a gluten-containing diet

Answer

Start a strict gluten-free diet immediately without further testing

Answer

Arrange colonoscopy to exclude colorectal cancer only

Answer

Reassure her and repeat serology in 1 year

Answer

Start long-term corticosteroids

Practice question

A 28-year-old woman presents with chronic fatigue and intermittent watery diarrhoea. She has lost 6 kg over 6 months. Examination reveals mild pallor and a BMI of 18 kg/m². Her tissue transglutaminase IgA antibodies are strongly positive. What is the most appropriate next step?