Coeliac disease

Question 1

What is Coeliac disease?

Answer 1

An autoimmune condition where exposure to gluten causes inflammation of the small intestine (particularly the jejunum)

Question 2

When does Coeliac disease usually develop?

Answer 2

Early childhood

Question 3

Which autoantibodies are produced in response to gluten in Coeliac disease?

Answer 3

• Anti-tissue transglutaminase (anti-TTG)

- Anti-endomysial (anti-EMA)

Question 4

What histopathological finding is present in Coeliac disease?

Answer 4

Crypt hyperplasia and villous atrophy

Question 5

Coeliac disease is often asymptomatic… True or false?

Answer 5

True

Question 6

Which skin rash is associated with Coeliac disease?

Answer 6

Dermatitis herpetiformis

Question 7

Which group of patients are automatically tested for Coeliac disease, even if they have no symptoms? Why is this?

Answer 7

New cases of T1DM (as the conditions are often linked)

Question 8

How do you test for Coeliac disease?

Answer 8

• Test for autoantibodies (anti-TTG and anti-EMA) while the patient remains on a diet containing gluten
• Must also test total IgA levels (as IgA deficiency will result in a negative test even if the patient has Coeliac disease)

Question 9

Describe the management of Coeliac disease

Answer 9

Lifelong gluten free diet