coeliac Flashcards
production of two antiboies in coeliac?
anti-gliadin, and anti-endomysial
immune reaction (t cells) to what in wheat fluid?
gliadin
what does immune reaction do to enterocytes and their absorption capacity?
damages them and reduces
what skin condition is it associated with?
dermatitis herpatiformis
when can it present?
childhood, middle age or adulthood
where does it affect?
proximal small bowel
what do you get on histology ?
loss of villous structure, loss of surface area, reduction in absorption and a flat duodenal mucosa
“flat mucosal surface”
czak villous atrophy
which test is very sensitive?
duodenal biopsy
apart from biopsy, what is the test for diagnosis?
IgA anti tissue transglutaminase test (TTGa)
why do you get general tiredness?
due to iron deficiency anaemia
anti ttg is a type of what antibody?
igA
which HLAs are associated with celiac?
DQ2/8
what symptom do you get as a result of malabsorption of fats?
steatorrhoea
histological findings typically?
hypertrophy of the crypts and atrophy of the villi, giving the villi a flattened appearance
which two antibodies associated with coeliac?
anti ttg and anti endomysial
anti ttg is a form of ?
IgA
there is no criteria for diagnosis of coeliac, but you need ? (4)
evidence of malabsorption
villous atrophy on duodenal biopsy
weight loss
features resolve upon starting gluten free diet
what is the most specific diagnostic test ?
villous atrophy on duodenal biopsy
osteopenia is a known complication of coeliac. why would this be ?
due to lack of calcium absorption
what would you therefore arrange for patients?
regular DEXA bone scanning
on diagnosis, patients should be referred to dietician. what kind of foods contain gluten?
Pasta Bread Cereals Biscuits Pastries / pies Crumbed foods Pizza
There must also be an increase in the number of inflammatory cells in the _________ for a diagnosis to be made
lamina propria
what sort of diseases is coeliac linked with ?
other autoimmune conditions - T1DM, thyroid, addisons
