Coeliac disease Flashcards
What is coeliac disease?
An autoimmune disorder, primarily affecting the small intestine, where individuals develop intolerance to gluten
What are the symptoms of coeliac disease?
Classic symptoms include gastrointestinal problems such as chronic diarrhoea, steatorrhoea, abdominal distention, malabsorption, loss of appetite, and among children failure to grow normally
When does coeliac disease most typically first present?
6 moths - 2 years old
What specific compounds does the intestine react to in coeliac disease?
Gliadins and glutenins
What genetic variant do most people with coeliac disease have?
HLA-DQ2
How is the immune response triggered in coeliac disease?
Gliadin disrupts tight junction between intestinal cells, allowing larger molecules to pass
Membrane leaking triggers two immune responses: innate and adaptive
Release of interleukin-15 to alpha-2-gliadin fragment and increase in inflammatory chemicals
What are risk factors for developing coeliac disease?
Genetic predisposition, type 1 diabetes, autoimmune thyroid disease, Down and Turner syndrome
How do you diagnose coeliac disease?
Serological test for IgA and IgA tissue transglutaminase
History
How do you manage coeliac disease?
Gluten-free diet. This leads to recovery of the intestinal mucosa, improves symptoms, and reduces the risk of developing complications in most people
If untreated, it may result in cancers such as intestinal lymphoma, and a slightly increased risk of early death
What would a coeliac disease biopsy show?
Duodenal biopsy shows flattening of villi and increased lymphocytes in the lamina propria and surface epithelium. In addition, there is gross crypt hyperplasia
A patient’s duodenal biopsy shows flattening of villi and increased lymphocytes in the lamina propria and surface epithelium. In addition, there is gross crypt hyperplasia.
What is your diagnosis?
Coeliac disease
