Celiac disease Quiz: Ace Your Exams
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A 12-year-old boy is brought to the pediatrician due to several months of recurrent episodes of bloating and diarrhea that are worse after eating. He has also unintentionally lost 6 lbs (2.7 kg) over this same time. Several weeks ago, he developed a pruritic rash on the bilateral forearms. One year ago, he was hospitalized after a motor vehicle accident and experienced an episode of anaphylactic shock after receiving a blood transfusion. He has no recent history of travel. Physical examination shows conjunctival pallor. There are multiple tense, grouped subepidermal blisters on the elbows and dorsal forearms bilaterally. There is also mild tenderness to palpation throughout the abdomen. Laboratory studies from his previous hospitalization are shown below. Which of the following diagnostic studies is the most appropriate next step?
| Immunoglobulins, serum | |
| IgA | <5 mg/dL (low) |
| IgG | 1200 mg/dL (normal) |
| IgM | 325 mg/dL (normal) |
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