Celiac Disease

Question 1

What are the common GI symptoms of celiac disease?

Answer 1

Bloating, diarrhea, abdominal pain, constipation, steatorrhea, indigestion

Question 2

Common nutritional deficiency in celiac disease?

Answer 2

Anemia - iron, folate. Vitamins D and K.

Question 3

What are symptoms associated with growth?

Answer 3

Short stature, delayed puberty

Question 4

Extra-intestinal symptoms of celiac?

Answer 4

Arthritis, aphthous stomatitis, dermatitis herpetiformis, osteoporosis/malasia, infertility/abortion, other autoimmune disease, especially T1DM, and thyroid. IgA deficiency

Question 5

Neurologic symptoms associated with celiac?

Answer 5

Ataxia, epilepsy

Question 6

Psychiatric symptoms associated with celiac?

Answer 6

Anxiety, depression

Question 7

Aphthous stomatitis

Answer 7

cancer sores

Question 8

IgA

Answer 8

Immunoglobulin found in mucosal surfaces, colostrum,

Question 9

Ataxia

Answer 9

Lack of muscle coordination

Question 10

Tissue transglutaminase

Answer 10

An enzyme found in the lamina propria of the small bowel. It deamidates glutamine residues in gluten to form glutamic acid.

Question 11

Dermatitis herpetiformis

Answer 11

Is caused by exposure to gluten, a cutaneous manifestation of small intestinal immune mediated enteropathy. IgA is deposited in-between the derma-epidermal layer. Pruritic papulovesicular rash, generally on the buttocks, elbows, knees.

Question 12

What 3 antibodies are tested for to diagnose CD?

Answer 12

anti-tissue transglutaminase (tTG), anti-endomysium (EMA), anti-deamidated gliadin peptides (DGP)

Question 13

silent CD

Answer 13

Adult. Positive serology, positive biopsy, no symptoms

Question 14

latent CD

Answer 14

Adult. +/-serology. normal biopsy. May have no symptoms, or GI &/or extra-intestinal symptoms, have have gluten dependent enteropathy at some point in their life.

Question 15

potential CD

Answer 15

Any age. positive serology, negative biopsy, may or may not have symptoms

Question 16

What histological changes occur to the mucosa in CD

Answer 16

villous atrophy, crypt hyperplasia, increased intraepithelial lymphocytes

Question 17

“typical” celiac disease

Answer 17

Toddler, young child. GI symptoms. + serology, +biopsy

Question 18

“atypical” CD

Answer 18

Older child, adult. Mostly extra-intestinal symptoms. +serology, +biopsy,

Question 19

What 3 grains contain gluten?

Answer 19

wheat, barley, rye

Question 20

What 3 serological test are used to diagnosis CD?

Answer 20

Anti-human tissue transglutaminase, IgA endomysial antibody immunofluorescence, and immunoglobulin IgA

Question 21

What is the estimated prevalence of CD in the US?

Answer 21

1 in 133

Question 22

What is the prolamin in barley?

Answer 22

hordein

Question 23

What is the prolamin in wheat?

Answer 23

gliadin

Question 24

What is the prolamin in rye?

Answer 24

secalin

Question 25

Prolamins

Answer 25

glutamine rich storage proteins found in the endosperm of grain.

Question 26

What are the most common vitamin/mineral deficiencies in CD?

Answer 26

Vit D, calcium, iron, folate

Question 27

What is the classic presentation of CD

Answer 27

weight loss, fatigue, diarrhea

Question 28

Triticale

Answer 28

Hybrid of wheat and rye; contains gluten

Question 29

All varieties of wheat must be avoided. What are they?

Answer 29

Einkorn, emmer, spelt, kamut

Question 30

What are other forms of wheat that must be avoided?

Answer 30

Wheat starch*, wheat bran, wheat germ, cracked wheat, hydrolyzed wheat protein.

Question 31

What is the current FDA proposal concerning wheat starch?

Answer 31

Foods made with wheat starch may be labeled gluten-free if they contain less than 20ppm.

Question 32

What grains may be included in the diet?

Answer 32

Rice, corm, amaranth, quinoa, tef, millet, finger millet, sorghum, montina (indian rice grass), arrowroot, buckwheat, flax, Job's tears, sago, potato, soy, legumes, mesquite, tapioca, wild rice, cassava (manioc), yucca, nuts, seeds.

Question 33

What is the prolamin in oats?

Answer 33

avenin

Question 34

What is a safe level of oats for CD patients to consume?

Answer 34

50g dry oats per day

Question 35

Other terms for wheat?

Answer 35

flour, white flour, plain flour, bromated flour, enriched flour, phosphates flour, self-rising flour, Durum, farina, semolina, graham flour.

Question 36

What foods are derived from barley?

Answer 36

Beer, ale, porter, stout. Malt, malt syrup/extract. Malt beverages, milk, vinegar.