MRCP2-2000

MRCP2-2000

A 42-year-old woman presents to the gastroenterology clinic with a 6-month history of weight loss, fatigue, and diarrhoea. She has a history of scleroderma for the past 12 years but has not taken any medications for it. Her symptoms are not exacerbated by any particular foods, and she maintains a varied diet. During examination, skin bruising and a peripheral neuropathy in a glove-and-stocking distribution were noted.

The following investigations were conducted:
– Hb: 108g/l (115-165)
– MCV: 103fl (80-96)
– WBC: 10.2 * 109/l (4.0-11.0)
– Serum vit B12: 140 ng/l (160-760)
– Serum folate: 10.5µg/l (2.0-11.0)
– CRP: 130 mg/l (<10)
– Anti TTG antibodies: negative

What would be the most appropriate initial investigation to establish a diagnosis?