Abdominal: Coeliac disease (brief) Flashcards
what is coeliac disease?
autoimmune disorder in which a heightened immunological response to gluten
what does coeliac disease result in/cause?
chronic inflammation and damage (villous atrophy) to the lining of the small intestine = malabsorption of nutrients
with reference to coeliac disease, which auto-antibodies are created in response to gluten?
anti-TTG and anti-EMA
what is refractory coeliac disease?
the persistence or recurrence of otherwise unexplained malabsorptive symptoms and villous atrophy despite adhering to a gluten-free diet
what are clinical features of coeliac disease?
- unexplained, persistent, GI symptoms
- failure of growth in children
- unexpected weight loss
- fatigue.
- iron/B12/folate deficiency
- IBD
what differential diagnosis could you offer for coeliac disease?
- IBD/IBS
- malignancy
- infectious (TB or HIV)
- milk allergy
- aphthous ulcer
what investigation would you conduct to diagnose coeliac disease?
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.
what is the treatment for coeliac disease?
long-term gluten free diet is only effective treatment