Diagnostic Challenges of Celiac Disease

Autoimmune Enteropathy²

June 2010

In this case, the patient underwent further serologic testing and this illustrates the immunofluorescence pattern of antigoblet cell antibodies, that is suggestive of the condition of autoimmune enteropathy. This patient, had these antigoblet cell antibodies detected as part of the antienterocyte antibody test. Additionally, HLA genetic susceptibility typing for celiac disease identified the patient carried the genes that encoded DQ6 and not the genes that encoded the celiac susceptibility HLA types of now, or previously called, DQ2 or DQ8. This patient responded to steroids and Azathioprine for his disease that was not celiac disease.

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Autoimmune Enteropathy2

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Jump to section:

• Introduction
• Case 1: Negative Serology for Celiac Disease
• Limitations of Serology
• Case 2: Symptomatic Malabsorption
• Biopsy First?
• Comparison of Serological Tests
• Comparison of Serological Tests
• Marsh Classification
• Autoimmune Enteropathy²
• Autoimmune Enteropathy²
• False-Positive Biopsies
• False-Positive Biopsies
• Minimal Disease: Uncertain Histology
• Lymphocytic Duodenosis⁴
• Patient Presenting on Gluten-free Diet
• What About Patients on Gluten-free Diet?
• Gluten Challenge Testing
• Celiac Disease and HLA Risk
• Genetic Tests-Big Limitation⁵
• References
• Questions?