Which test is first-line to screen for coeliac disease in an adult who is still eating gluten?
Answer and explanation
Correct answer: A. Serum IgA tissue transglutaminase with total IgA
- Step 1: Serology is only reliable while gluten is in the diet, because antibodies fall once it is excluded. Step 2. Tissue transglutaminase IgA is the screening test of choice, with total IgA checked because IgA deficiency gives false negatives. Answer: Serum IgA tissue transglutaminase with total IgA. Why not the others: Calprotectin screens for inflammatory bowel disease. A lactose breath test diagnoses lactose intolerance. Antimitochondrial antibodies are associated with primary biliary cholangitis.
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