Which additional test might be performed when diagnosing celiac disease despite negative antibody tests?

Which additional test might be performed when diagnosing celiac disease despite negative antibody tests?

• A. Initial blood glucose level
• B. Comprehensive metabolic panel
• C. HLA typing for DQ2/DQ8
• D. Complete blood count (CBC)

Answer: (C)

When diagnosing celiac disease, especially in cases where initial antibody tests come back negative but clinical suspicion remains high, HLA typing for DQ2/DQ8 is a crucial additional test. This test assesses whether an individual carries specific human leukocyte antigen (HLA) genes that are often linked to celiac disease. HLA-DQ2 and HLA-DQ8 are variants that are present in the majority of individuals who have celiac disease; however, their presence alone does not confirm the disease, as they can also be found in a significant portion of the general population. Thus, while it is a very useful tool for ruling out celiac disease—if neither of these HLA types is present, it is highly unlikely that the patient has celiac disease—it does not diagnose it on its own. This is particularly important in cases where a patient exhibits classic symptoms of the disease and has negative serological tests. The other tests listed—initial blood glucose levels, a comprehensive metabolic panel, and a complete blood count—do not provide direct evidence regarding the presence of celiac disease and thus are not specifically helpful for the diagnosis in this context. Blood glucose tests are more closely related to diabetic conditions, the comprehensive metabolic panel assesses a variety

When diagnosing celiac disease, especially in cases where initial antibody tests come back negative but clinical suspicion remains high, HLA typing for DQ2/DQ8 is a crucial additional test. This test assesses whether an individual carries specific human leukocyte antigen (HLA) genes that are often linked to celiac disease.

HLA-DQ2 and HLA-DQ8 are variants that are present in the majority of individuals who have celiac disease; however, their presence alone does not confirm the disease, as they can also be found in a significant portion of the general population. Thus, while it is a very useful tool for ruling out celiac disease—if neither of these HLA types is present, it is highly unlikely that the patient has celiac disease—it does not diagnose it on its own. This is particularly important in cases where a patient exhibits classic symptoms of the disease and has negative serological tests.

The other tests listed—initial blood glucose levels, a comprehensive metabolic panel, and a complete blood count—do not provide direct evidence regarding the presence of celiac disease and thus are not specifically helpful for the diagnosis in this context. Blood glucose tests are more closely related to diabetic conditions, the comprehensive metabolic panel assesses a variety