Anders Anderson, was seen by his pediatrician at 24 months old after a recent bout of diarrhea and vomiting. He had lost his appetite and complained that his stomach hurt

Question

Anders was in the 5% centile for weight, had slender limbs, wasted buttocks, and a protuberant abdomen. Jejunal biopsy revealed abnormal surface epithelium, and villous atrophy with hyperplasia of the crypts. Which of the following would be a likely clinical finding in this patient?
a. glomerulonephritis
b. urticarial rash
c. anti-gliadin IgA antibodies
d. chronic wheezing
e. low blood pressure.

Answer 1

Rationale: The correct answer is c. This is a case of celiac disease, also known as gluten-sensitive enteropathy. An inflammatory response involving CD4 T cells is made against gluten proteins (including gliadins and glutenins) in gut-associated lymphoid tissues. Anti-gliadin and anti-glutenin IgA antibodies are secreted into the lumen of the gut. Atrophy of intestinal villi compromises absorption and, as seen in this case, affected children fail to thrive.