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Celiac disease with IgA deficiency — RCPSC IM MCQ

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ModerateGastroenterology/HepatologyCeliac disease with IgA deficiencyRCPSC IM

A 29-year-old woman has chronic diarrhea, bloating and iron deficiency. Her total IgA is undetectable. Tissue transglutaminase IgA is negative. She has not changed her diet and continues to eat wheat daily. What is the most appropriate investigation?

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Correct answer: D — IgG-based celiac serology such as deamidated gliadin peptide IgG with duodenal biopsy if positive

IgA deficiency can cause false-negative IgA-based celiac serology. IgG-based serology and duodenal biopsy while on gluten are appropriate.

Reference: Canadian Association of Gastroenterology celiac disease guidance