Immunology: HLA association in coeliac disease: practice question

A Microbiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Microbiology · Immunology: HLA association in coeliac disease

Sample item

A 28-year-old woman with iron-deficiency anaemia, chronic diarrhoea and positive IgA anti-tissue transglutaminase antibodies has villous atrophy on duodenal biopsy. Which HLA association is characteristic of her condition?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. HLA-DQ2 or HLA-DQ8

Nearly all patients with coeliac disease carry HLA-DQ2 or DQ8, which present deamidated gliadin peptides to CD4 T cells. A negative result makes the diagnosis very unlikely, but the alleles are also common in the healthy population. HLA-B27 is associated with ankylosing spondylitis, B51 with Behcet disease and B*57:01 with abacavir hypersensitivity.

Option by option

  • A. HLA-B27

    HLA-B27 is associated with ankylosing spondylitis and reactive arthritis.

  • B. HLA-B51

    HLA-B51 is associated with Behcet disease.

  • C. HLA-B*57:01

    HLA-B*57:01 predicts abacavir hypersensitivity.

  • D. HLA-DQ2 or HLA-DQ8 (correct)

    Correct. DQ2 and DQ8 present gliadin peptides and are found in almost all patients with coeliac disease.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Microbiology questions

Questions about this Microbiology question

What is the answer to this Microbiology question?

The best answer is D, HLA-DQ2 or HLA-DQ8. Nearly all patients with coeliac disease carry HLA-DQ2 or DQ8, which present deamidated gliadin peptides to CD4 T cells.

Why is "HLA-B27" not the answer?

HLA-B27 is associated with ankylosing spondylitis and reactive arthritis.

Why is "HLA-B51" not the answer?

HLA-B51 is associated with Behcet disease.

Why is "HLA-B*57:01" not the answer?

HLA-B*57:01 predicts abacavir hypersensitivity.

What concept does this question test?

It tests Immunology: HLA association in coeliac disease in Microbiology. A negative result makes the diagnosis very unlikely, but the alleles are also common in the healthy population. HLA-B27 is associated with ankylosing spondylitis, B51 with Behcet disease and B*57:01 with abacavir hypersensitivity.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Immunology: HLA association in coeliac disease?

Make a one-line identity card for each organism: shape and stain, defining test, toxin, disease and drug. Then use the flashcards and the other Microbiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.