Celiac Flashcards
WHat diagnostic procedure will you do to confirm your diagnosis? What might you see?
Endoscopy. You might see abnormal duodenal walls. Under a microscope you might see an increase in inflammatory cells.
Why might celiac be difficult to diagnose early on?
Often inflammatory disease might be present until years later.
Why do patients who have Celia have their response to gluten???
Patients with CD express HLA-DQ2 (Human Leukocyte Antigen), which facilitates the immune response against gluten protein. This explains 40% of celiac.
Why is there a comorbidity between Type 1 Diabetes and Celiac Disease?
Overlapping genetic HLA risk loci. The HLAs are important determinant of disease susceptibility in both diseases.
Explain what gliadin is and what it causes?
Gluten can get broken down in gliadin, which can activate immune cells in the gut lamina propria, and recruit infiltrating T lymphocytes. DQ molecules then binds to the gliadin peptide fragment and Presents it to T cells. This initiates adaptive Th1 response and increased interferon gamma and interleukin-15 release. This activates intraepithelial lymphocytes and induces profound tissue remodeling.
How do you make a Diagnosis Of CD?
Serology - First choice is IgA anti-tTG antibodies, with anti-endomysial antibodies (EmA) if still uncertain.
Small bowl biopsy - usually done before recommending taking on the celiac diet for life
- under histology you might see mucosal inflammation, increased number of intraepithelial lymphocytes, crypt hyperplasia, and villus atrophy.
Genetic testing for HLA
Why is H2 a good test to determine CD?
Because all of the things that should be digested and absorbed in the SI are now making their way into the colon and are being broken down and digested by bacterial enzymes, which give off H2 as a byproduct.
Why is a DEXA scan helpful in making a diagnosis of celiac?
Because patient is malnourished their vitamin/mineral levels are down they will have decreased bone mineral density.
How do you treat CD?
Correct nutritional deficiencies, GF diet, multivitamin, folic acid for women of child-bearing age.
Symptoms of celiac disease
Short, skinny, irritable, pale, distended abdomen, abdomen is hypertympanic, gluteal wasting, could be anemic due to malnutrition, could have a deficiency in a lot of vitamins.
Dermatitis herptiformis is a common symptom.
- clubbed fingers,
