Coeliac disease

Question 1

[…] cell-mediated inflammatory autoimmune disease affecting the […] bowel in which sensitivity to […]

Answer 1

T , small, prolamin (of which gliadin is a type),

Question 2

Associations
- positive family history
- HLA-[…]
- other autoimmune disease (such as […])

Answer 2

DQ2
T1DM

Question 3

GI Features
- Abdominal pain
- Distension
- Nausea and vomiting
- Diarrhoea
-[…]

Answer 3

Steatorrhoea

Question 4

Key systemic features
- […] […] or failure to […] in children
- […] stature and wasted buttocks
- pallor (anaemia 2ndary to malabsorption)
- […] (vit K malabsorption)
- skin: […] […] - vesicular rash around buttocks and extensor surfaces

Answer 4

Weight loss, thrive
short
bruising
dermatitis herpetiformis

Question 5

Autoimmune disease associated with coealiac

Answer 5

T1DM
Grave’s or Hashimoto’s

Question 6

Diagnosis
- […] […] antibody - measured with […] level (if deficient –> false negative –> use Anti-TTG IgG instead)
-[…] […] antibody if TTG IgG is weakly positive
- gold standard diagnostic test - […] and duodenal/jejunal […]
- […] culture is necessary to exclude infection

Answer 6

Anti-TTG IgA, IgA
OGD, biopsy
stool
Anti-EMA

Question 7

Mx
- Life-long […]-free diet
- Patient education
- Follow up
Adherence to diet and […] screen

Answer 7

Gluten
complication

Question 8

Complications
- […] (secondary to iron, B12 or folate deficiency)
- […] (and therefore a susceptibility to encapsulated organisms)
- Osteoporosis (a […] scan may be required)
- Enteropathy-associated T cell lymphoma (EATL; a rare type of non-Hodgkin lymphoma). - the more a patient breaks adherence, the more likely they are to get EATL.

Answer 8

Anaemia
Hyposplenism
DEXA

Question 9

What lymphoma is associated with coeliac disease

Answer 9

Enteropathy-associated T cell lymphoma (EATL; a rare type of non-Hodgkin lymphoma). - the more a patient breaks adherence, the more likely they are to get EATL.