Coeliac Flashcards
1
Q
Symptoms
A
Diarrhoea Steatorrhoea Abdo pain Bloating, flatulence, constipation, indigestion Fatigue Unexplained weight loss Dermatitis herpetiformis
2
Q
Pathophysiology
A
Gliadin protein resists breakdown - binds to IgA to form complex - bind to TFR - transcytosed across enterocyte + into lamina propria - tTg deamidates - phagocytosed by MHC - presented on MHC II - Th activated - TNF + IFN - destroy epithelial cells in villi + produce auto ABs against gliadin, EMA + tTg - also, recruit CD8 T cells which destroy inflammed cells
3
Q
Characteristics
A
Damage mostly in duodenum
Flattened villi + crypt hyperplasia
Infiltration of immune cells
Get dermatitis herpetiformis
4
Q
Epidemiology
A
1% of UK pop
4 fold increase in diagnosis in last 20 years
500,000 undiagnosed
5
Q
Causes
A
Family hx - HLA-DQ2 or DQ8 Rotavirus as a child T1D Down Syndrome Thyroid problems
6
Q
Diagnosis
A
Must still be eating gluten Total IgA + IgA tTG = 1st choice Can look at auto-ABs e.g. anti-EMA, anti-tTg FBC - look for anaemia Biopsy confirms diagnosis
