Gastroenterology

Question 1

What is the skin finding suggestive of celiac disease?

Answer 1

Dermatitis herpetiformis - pruritic papular eruption over the extensor surfaces around elbows, knees, buttocks is a well recognized manifestation of celiac disease (secondary to IgA deposition on the skin)

Question 2

What is the role of HLA (HLA-DQ2 or HLA-DQ8) testing in patients with celiac disease?

Answer 2

Routine testing is not recommended
Testing should be done in cases where there is a diagnostic dilemma
A negative HLA test will effectively rule out the disease but a positive HLA test does not say much (Approximately 40% of the general population is HLA-DQ2 positive and only 1-2% will develop celiac disease)

Question 3

What is the gold standard for diagnosing celiac disease?

Answer 3

Endoscopy

Question 4

What are the typical endoscopic findings for celiac disease?

Answer 4

Villous atrophy with crypt hyperplasia

Increase intraepithelial lymphocytes