A 45-year-old woman presents with chronic diarrhoea, weight loss, and a skin rash with erythematous vesicles on elbows and knees. Duodenal biopsy shows subtotal villous atrophy with increased intraepithelial lymphocytes. Which HLA types are MOST strongly associated with this condition?
- A HLA-DQ2 and HLA-DQ8 ✓
- B HLA-B27
- C HLA-DR3 and HLA-DR4
- D HLA-A3
Correct answer: A. HLA-DQ2 and HLA-DQ8
Explanation
Coeliac disease (gluten-sensitive enteropathy) with dermatitis herpetiformis is strongly associated with HLA-DQ2 (present in ~90-95% of coeliacs) and HLA-DQ8 (~5% of the remainder); >99% of coeliac patients carry at least one of these alleles. HLA-B27 is associated with ankylosing spondylitis and reactive arthritis. HLA-DR3/DR4 is associated with type 1 diabetes. HLA-A3 is associated with hereditary haemochromatosis.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.