Celiac Disease Lecture Powerpoint

Question 1

Celiac disease definiton

Answer 1

Condition in which there is abnormal small intestinal mucosa that improves morphologically when treated with gluten free diet and relapses when reintroduced, a malabsorptive immune mediated disorder triggered by an environmental agent in genetically predisposed individual causing immune mediated small bowel inflammation decreased absorption of food and essential nutrients, MUST have genes HLA-DQ2 and HLA-DQ8 in order to be considered

Question 2

Current literature and infants introduction of gluten

Answer 2

Recommended to eat less than 5g of gluten containing food on average per day from 4-6 months continuing until age 2

Question 3

Classic signs and symptoms in celiac disease patients (6)

Answer 3

• foul smelling diarrhea
• excess flatulence
• growth failure in children
• iron deficient anemia
• dermatitis herpetiformis (maculopapular on the extensor suraces)
• concomitant lactose intolerance

Question 4

Diagnostic testing for celiac disease (5)

Answer 4

• all testing should be done while patient is ON a gluten rich diet except genetic testing***
• serologic eval IgA tissue transglutaminase and/or IgA endomysial antibody
• total IgA (in case IgA deficient)
• genetic testing (patient might still have gluten sensitivity but not celiac)
• modified gluten challenge and small bowel biopsy (at least 6 specimen) (confirmatory)

Question 5

Upon biopsy for celiac testing, any patient with ____ would benefit from a gluten free diet

Answer 5

villous atrophy

Question 6

Lactose intolerance tesing (1)

Answer 6

hydrogen breath testing

Question 7

Management of celiac disease (3)

Answer 7

• consult with skilled dietician
• gluten free diet
• support and followup

Question 8

Risks of celiac disease (4)

Answer 8

• low birth weight infants
• micronutrient deficiencies
• risk for other autoimmune disorders
• increased overall mortality and malignancy

Question 9

Monitoring response to gluten free diet (4)

Answer 9

• symptoms improve faster than histology
• followup studies including serologies
• nonresponders might be poor compliance or inadvertent ingestion
• can have type 1 or 2 refractory celiac dz that can be serious and require immunosuppression