QuestionSBA
QuestionChoice
This is a genetic test for genes which are associated with coeliac disease. It is typically reserved for children found to have a positive TTGA, and is used in such patients in place of biopsies.
10000679
d
Testing for HLA-D2 and HLA-DQ8
QuestionChoice
This may be used to investigate for coeliac disease, as a raised endomysial IgA does indicate coeliac disease. The test is 100% specific, but only 90% sensitive - making TTGA the preferred, first-line, test due to it's higher sensitivity.
10000677
b
Endomysial IgA
QuestionChoice
This is a test used to measure inflammation of the intestine, and is used to screen for inflammatory bowel disease (IBD) e.g. Crohn's Disease or Ulcerative Colitis. It may be used to screen this patient for IBD. However, it would not be diagnostic for coeliac disease.
10000680
e
Faecal calprotectin
QuestionChoice
A series of duodenal biopsies can be used to confirm a diagnosis of coeliac disease. Diagnosis is confirmed by seeing villous atrophy, crypt hyperplasia, and increased lymphocytes when a person is consuming gluten. Villous atrophy should then be seen to recover on a gluten-free diet. However, a biopsy is only carried out after initial blood tests. The first-line investigative blood test specifically for coeliac disease is TTGA.
10000678
c
Duodenal biopsy via upper GI endoscopy
QuestionChoice
This is the first-line investigation for coeliac disease. It is 98% sensitive and 96% specific. If positive, then further tests may be carried out to confirm the diagnosis e.g. biopsies. It should also be ordered alongside a test for total IgA because if the person has an IgA deficiency, TTGA may not be detected even if the person does have coeliac disease.
10000676
a
Tissue transglutamase IgA (TTGA)
Concept
Chapter
2693
3807
Coeliac Disease
Topic
162
General practice
12682
Which of the following tests would be first-line for the investigation of a patient with suspected coeliac disease?
a