Celiac Disease

Question 1

What is celiac disease?

Answer 1

Immune mediated condition where there is intolerance to gluten(wheat)
but also -BRO- Barley, Rye and Oats(Non harmable if in pure form)

Question 2

Pathophysiology of celiac disease?

Answer 2

Intake cereals(gluten)—> Convert into GLIADIN—> Comes in contact with intestinal mucosa where they enters through it—> Contact with enzyme called TISSUE TRANSGLUTAMASE—> Deamination of GLIADIN—> Deaminated GLIADIN comes contact with Macrophage(APC)—> Activates CD4 T-cell and CD8 T-cell—> Secretion of cytokines—> Attack on Enterocytes.

Additionally CD4 T-cell also helps in fascilitation of Ab(Serological marker)

Question 3

CD4 T-cell and CD8 T-cell lead to ?

Answer 3

1- Villious atrophy
2- Increase mitotic rate of epithelial cell- Crypt hyperplasia

Increase in intraepithelial lymphocytes(In the mucosal tissue)

Question 4

C/F in children?

Answer 4

Recurrent Diarrhea, Abdominal distension, bloating, vomiting and even constipation
Hematological: Iron refractory anemia means even if u r giving Fe it is not improving
Skeletal: Rickets, Osteoporosis, dental enamel changes, muscular atrophy
Neurological: irratibility, peripheral neuropathy
Endocrine: Short stature

Question 5

Diagnosis of celiac disease?

Answer 5

TotallSerum total IgA + anti ttG(tissue transglutamase)IgA…BEST ONE

2 scenarios is possible: 1) anti ttG IgA elevated or 2) Remains normal

If the anti ttG IgA elevated and it is elevated >10* times then it is recommended to do blood sample anti endomycil Ab in that and if that is also elevated then celiac disease is confirmed

Question 6

Types of anti ttG IgA elevation?

Answer 6

1-