Coeliac Disease Flashcards
what is coeliac disease
autoimmune condition which results in a sensitivity to gluten, causing inflammation as well as villi atrophy
what can coeliac disease lead to
chronic intestinal malabsorption
aetiology
the body is sensitive to gliadin which is a component of gluten; ingestion leads to an immunological reaction in the small bowel which leads to villi atrophy as well as mucosal damage
risk factors
family Hx as there is genetic susceptibility (10% first degree)
type 1 diabetes and autoimmune thyroid (autoimmune diseases make you more susceptible to more autoimmune conditions)
IgA deficiency
epidemiology of coeliac disease
UK; 1/2000
Western Ireland; 1/300
East Asia; rare
Presenting symptoms of coeliac disease
bloating, abdominal discomfort, pain and abdominal distension, steatorrhoea, diarrhoea, tiredness, malaise and unintentional weight loss, failure to thrive in children, amennhorea in young adults, osteopenia and osteoporosis
can coeliac disease be asymptomatic
yes
what is steatorrhoea
too much fat in faeces, white bulky stool, offensive smell and more difficult to flush
Physical Examination findings
signs of anaemia (pallor),
signs of malnutrition (short stature, abdominal distension, wasted buttocks in children)
signs of vitamin and mineral deficiency (osteomalacia and easy bruising)
dermatitis herpetiformis
what vitamin deficiency leads to osteomalacia
D
what vitamin deficiency leads to easy bruising
C and K
what investigations will be done to diagnose Coeliac disease
bloods, serology, stool tests, endoscopy and biopsy
what would you look for in bloods
FBC, U&E’s, albumin, calcium (osteoporosis is a complication and leads to low calcium), phosphate (high phosphate)
serology investigation
IgG anti-gliadin antibodies (IgAandG anti-endomysial antibodies can be diagnostic factors for coeliac and dermatitis herpetiformis)
why don’t you rely solely on IgA levels
IgA deficiency is quite common (1/50) and won’t always mean the patient is coeliac