A 14 year old boy presents with chronic diarrhea. Duodenal biopsy shows villous atrophy. Anti endomysial antibodies and IgA TTG antibodies are positive. What is the treatment of choice?: (A) Gluten free diet, (B) Antibiotics, (C) Loperamide, (D) 5-ASA
Answer is A. Chronic diarrhea, villous atrophy of duodenal biopsy, anti-endomysial antibodies and IgA TTG antibodies are features of coeliac sprue. Management of coeliac sprue includes life long gluten free diet and correcting deficiencies of iron, folate and calcium. Ref: Davidson's principles and practice of Medicine, 20th Edition, Chapter 22, Page 894-896; Harrison's Principles of Internal Medicine, 16th Edition, Page 1772