Autoimmunity laboratory

Case Study

Coeliac disease

The best way or “gold standard” for determining whether a patient has coeliac disease is the take a sample (biopsy) of the intestine to see if there is any damage or “villous atrophy”. This procedure is extremely invasive so before a clinician performs such a procedure he needs more clues that point to coeliac disease. In this case the doctor took some blood from the patient and sent it to the immunology laboratory to look for abnormal antibodies that are found in patients with coeliac disease. These “auto-antibodies” are known to be targeted against a component in endomysial connective tissue called Tissue Transglutaminase. A healthcare scientist in the immunology department used immunofluoresence techniques to look for these antibodies and found relatively high concentrations. These results were reported back to the clinician who decided that along with significant evidence of malabsorption from tests carried out in the chemistry department including low iron and B12 levels, that coeliac disease was highly likely. This was confirmed by a bowel biopsy that showed damage consistent with advanced coeliac disease.

What do you think might be an appropriate treatment regime for a patient with coeliac disease?

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