30 year male with chronic diarrhoea, anemis, raised liver enzymes. Most likely associated with-: (A) Antimitochondrial antibody, (B) Anti-endomysial antibody, (C) Anti-smooth muscle antibody, (D) Antinuclear antibody
Answer is B. IgA anti-endomysial antibodies are found in 90% coeliac patients. They are a very specific & sensitive marker for coeliac disease and dermatitis herpetiformis. The anti-endomysial antibody test has been suggested to be 98% sensitive and 98% specific for clinical or subclinical coeliac disease Ref Davidson edition23rd pg 805