Affiliation:
1. Cardiff University, Cardiff, Wales, UK
2. Nevill Hall Hospital, Abergavenny, Wales, UK
Abstract
Anti-tissue transglutaminase antibodies (anti-tTG) play a vital role in the screening process for coeliac disease (CD). Levels above 30 U/ml suggest a possible diagnosis of CD, prompting further investigation, usually by taking a duodenal biopsy. We report an unusual case of 39-year-old male twins, one presenting with iron deficiency anaemia and the other asymptomatic, with anti-tTG antibodies of >4,965.5 U/ml, an extraordinary level. A duodenal biopsy confirmed a diagnosis of CD and following the adoption of a gluten-free diet, anti-tTG levels were found to decrease back to normal levels. This case demonstrates how CD can cause significant biochemical and histological pathology, but present with mild or no symptoms.
Subject
Education,General Medicine