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Diagnostic Challenges of Celiac Disease


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Case 1: Negative Serology for Celiac Disease

Slide 2

June 2010

The first case. A 45-year-old female patient with a 6-month history of diarrhea and bloating, is found to be anemic. She has a family history of a brother who has dermatitis herpetiformis. A tissue transglutaminase IgA test is performed and is negative. An endoscopy is performed and an endoscopic biopsy shows partial villous atrophy.

The next logical step is one of the following:
1. Treat her for bacterial overgrowth;
2. Give her iron and loperamide, an antidiarrheal agent;
3. Order an endomysial IgA, indirect immunofluorescence assay (IFA) test; or
4. Measure total IgA levels.

The correct answer in this case would be to measure total IgA levels.

Case 1


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