Coeliac Disease Flashcards
What is coeliac disease?
An autoimmune condition where exposure to gluten causes an immune reaction which leads to inflammation of the small bowel.
Which part of the small bowel is mostly affected by coeliac?
The jejunum
When does coeliac present?
It usually comes on in childhood but can occur at any age.
What is the pathophysiology behind coeliac?
Autoantibodies are created in response to exposure to gluten.
They target the epithelial cells in the intestine causing inflammation and villous atrophy.
Villous atrophy leads to malabsorption.
What are the autoantibodies created?
IgA Antibodies.
Anti TTG.
Anti EMA.
They rise and fall depending on how active the disease is.
What are the symptoms of coeliac?
Often asymptomatic Failure to thrive Not gaining weight Tiredness Weight loss Mouth Ulcers Diarrhoea Anaemia Dermatitis hepetiformis (on abdomen) Peripheral neuropathy Epilepsy Cerebellar ataxia Recurrent abdominal pain Cramping Distention
What causes anaemia?
2ndary to malabsorption of iron, folate and vitamin B12.
What condition is often seen with coeliac?
Type 1 diabetes
What genes are involved with coeliac?
HLA-DQ2
HLA-DQ8
When must investigations b e carried out?
When the person is still eating a diet containing gluten.
What investigations are done?
Total IgA (to exclude IgA deficiency)
Anti TTG antibodies
Anti EMA antibodies
Endoscopy (+Internal biopsies)
What will an endoscopy show?
Crypt hypertrophy and villus atrophy
What autoimmune conditions are often associated with coeliac?
Type 1 diabetes Thyroid diseas autoimmune hepatitis primary biliary cirrhosis primary sclerosing cholangitis
What is the treatment for coeliac?
Life long gluten free diet (this is curative)
What is the complications of coeliac?
Vitamin D deficiency Anaemia osteoporosis Ulcerated jejunum T cell lymphoma Non Hodgkins lymphoma Small bowel adenocarcinoma
