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Coeliac disease with IgA deficiency — ESEGH MCQ

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HardLuminal GICoeliac disease with IgA deficiencyESEGH

A patient stopped gluten before coeliac testing. HLA-DQ2 is present, serology is now negative and the patient wants diagnostic certainty. Which preparation does NICE advise before repeat testing?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Daily gluten at more than one meal for six weeks

E is correct. NICE advises gluten in more than one meal every day for at least six weeks before serology or biopsy. A is inadequate exposure. B misuses a common susceptibility genotype as confirmation. C cannot recreate antibody and mucosal responses. D reverses the sequence and makes a false-negative biopsy more likely.

Reference: NICE NG20: coeliac disease recognition and management: https://www.nice.org.uk/guidance/ng20/chapter/Recommendations