Coeliac disease Flashcards
What is coeliac disease?
Autoimmune condition autoantibodies in response to gluten exposure, target epithelual cells of small intestine causing inflamamtion
What two antibodies are ass with coeliac disease?
anti-tissue transglutiaminase (anti-TTG)
anti-endomysial (anti-EMA)
What do anti-EMA and anti-TTG correlate with>
THe severity of coeliac disease
May disappear with well managed disease
Where does inflammation in coeliac disease effect?
Small bowel esp jejunum
Atrophy of intestinal villi
Symptoms ass with coeliac disease
- Failure to thrive in young children
- Diarrhoea
- Fatigue
- Weight loss
- Mouth ulcers
- Anaemia secondary to iron, B12 or folate deficiency
- Dermatitis herpetiformis
Why is there a low threshold for testing for coeliac disease?
Often asymptomatic
What neurological symptoms can coeliac disease rarely present with?
- Peripheral neuropathy
- Cerebellar ataxia
- Epilepsy
What new diagnosis do you always test for coeliac disease with?
T1DM - often linked to coeliac
Gene ass with coeliac disease
HLA-DQ2
HLA-DQ8
What type of antibodie is anti-TTG and anti-EMA?
IgA
Why is it important to test for total IgA when testing for coeliac antibodies?
Can be IgA deficient whihc owuld mean negative result even with coeliac disease present
What investigations do if deficient in IgA?
IgG version of anti-TTG or anti-EMA antibodies
Endoscopy with biopsies
What does the patient have to do to prep for investigations?
Continue eating gluten
What is the first choice antibody detected for coeliac?
anti-TTG
What would coeliac disease show on a biopsy?
Crypt hypertrophy
Villous atrophy
