Coeliac Flashcards
What is Coeliac disease?
Autoimmune condition in which there I sensitivity to protein component of gluten
What type of hypersensitivity is coeliac disease?
Type 1 hypersensitivity
What is the protein in gluten?
Gliadin
What does repeated exposure to gliadin lead to?
Villous atrophy resulting in malabsorption
What does villous atrophy lead to?
Malabsorption
What is the genetic association with coeliac disease?
HLA-DQ2 (95%)
HLA-DQ8 (80%)
What symptomatic presentation does damage to the small bowel result in?
Copious loose foul-smelling stool which distends the abdomen.
(steatorrhea)
What does poor absorption through destroyed villi in the small bowel, lead to?
- Weight loss
- Muscle wasting
- Abdominal pain
- Failure to thrive.
What is the gold standard diagnostic tool for coeliac?
Small bowel biopsy (jejunal biopsy).
What would you find on a biopsy of someone with coeliac disease?
- Villous atrophy
- Crypt hyperplasia
- Increased epithelial lymphocytes.
What is the main serological markers for coeliac disease?
• Anti-tissue transglutaminase (Anti-TTG) (IgA)
What other serological markers could indicate coeliac disease?
- Anti-endomysial autoantibodies
What is the management of Coeliac disease?
Diet excluding gluten
What foods should be avoided?
wheat, rye, barley and some oats
What might you see on a jejunal biopsy in someone with coeliac disease?
Subtotal villous atrophy
What other conditions is coeliac associated with?
Type 1 diabetes
Autoimmune thyroid disease- Graves or Hashimotos thyroiditis
What dermatological manifestation is associated with coeliac disease?
Dermatitis herpetiformis
What are the possible complications of coeliac disease?
Anaemia
Hyposplenism
Osteoporosis
Enteropathy-associated T cell lymphoma
What cancer is associated with coeliac disease?
Enteropathy-assoictaed T cell lymphoma
What clincial signs might indicated coeliac disease?
pallor- anaemia
short stature and wasted buttocks- malnutrition
How can dermatitis herpetiformis present?
Pruritic papulovesicular lesions over the buttocks and extensor surfaces of the arms, legs, and trunk
