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Coeliac Disease — RACP Adult Medicine MCQ

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EasyGastroenterologyCoeliac DiseaseRACP Adult Medicine

A 25-year-old man with type 1 diabetes presents with Hb 100 g/L, MCV 72 fL, ferritin 8 μg/L, and transferrin saturation 6%. He reports bloating and loose stools. Anti-tissue transglutaminase (tTG) IgA is strongly positive. What is the most likely diagnosis?

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Correct answer: C — Coeliac disease

Iron deficiency anaemia with GI symptoms and strongly positive anti-tTG IgA in a patient with type 1 diabetes (associated autoimmune condition) is diagnostic of coeliac disease. Diagnosis requires duodenal biopsy showing villous atrophy (Marsh 3). Treatment is a lifelong strict gluten-free diet. Serology should normalise within 6–12 months.

Reference: Gastroenterological Society of Australia – 2024 – Coeliac Disease Guidelines