Young lady with weakness and anemia.
Endoscopy – diffuse scalloping of the duodenal mucosa
Biopsy – Mucosal flattening
Crypt hyperplasia
Intraepithelial lymphocytosis.
IgA anti-tissue transglutaminase (anti-TTG) NEGATIVE.
So, is this not celiac disease (CD)?
#GIpath #pathboards
Endoscopy – diffuse scalloping of the duodenal mucosa
Biopsy – Mucosal flattening
Crypt hyperplasia
Intraepithelial lymphocytosis.
IgA anti-tissue transglutaminase (anti-TTG) NEGATIVE.
So, is this not celiac disease (CD)?
#GIpath #pathboards
High clinical suspicion for CD -check IgA levels
In IgA deficiency, IgA-TTG and IgA-EMA (anti-endomysial Ab) will be negative
Alternative tests - IgG-DGP (deaminated gliadin peptide)/ IgG TTG
HLA-DQ typing - HLA-DQ2 (~95% pts) and HLA-DQ8
#GIpath #pathboards
In IgA deficiency, IgA-TTG and IgA-EMA (anti-endomysial Ab) will be negative
Alternative tests - IgG-DGP (deaminated gliadin peptide)/ IgG TTG
HLA-DQ typing - HLA-DQ2 (~95% pts) and HLA-DQ8
#GIpath #pathboards
Lastly, here's the colon bx of this pt showing lymphocytic colitis pattern
Microscopic colitis is more prevalent in pts w/ CD
Pts w/ MC and CD often have more severe histologic features, may require steroid rx
Response of MC to gluten free diet is not known.
#GIpath #pathboards
Microscopic colitis is more prevalent in pts w/ CD
Pts w/ MC and CD often have more severe histologic features, may require steroid rx
Response of MC to gluten free diet is not known.
#GIpath #pathboards
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