Abdominal: Coeliac disease (brief) Flashcards

1
Q

what is coeliac disease?

A

autoimmune disorder in which a heightened immunological response to gluten

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2
Q

what does coeliac disease result in/cause?

A

chronic inflammation and damage (villous atrophy) to the lining of the small intestine = malabsorption of nutrients

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3
Q

with reference to coeliac disease, which auto-antibodies are created in response to gluten?

A

anti-TTG and anti-EMA

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4
Q

what is refractory coeliac disease?

A

the persistence or recurrence of otherwise unexplained malabsorptive symptoms and villous atrophy despite adhering to a gluten-free diet

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5
Q

what are clinical features of coeliac disease?

A
  • unexplained, persistent, GI symptoms
  • failure of growth in children
  • unexpected weight loss
  • fatigue.
  • iron/B12/folate deficiency
  • IBD
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6
Q

what differential diagnosis could you offer for coeliac disease?

A
  • IBD/IBS
  • malignancy
  • infectious (TB or HIV)
  • milk allergy
  • aphthous ulcer
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7
Q

what investigation would you conduct to diagnose coeliac disease?

A

serology testing:

The NICE GDG recommends testing for immunoglobulin (IgA),tissue transglutaminase antibody (tTGA) first-line, and using IgA endomysial antibody (EMA) for cases where IgA tTGA is weakly positive, as this approach has high specificity and only slightly reduced sensitivity.

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8
Q

what is the treatment for coeliac disease?

A

long-term gluten free diet is only effective treatment

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