Coeliac Disease

Question 1

where does inflammation happen in coeliac disease?

Answer 1

small bowel (jejunum)

Question 2

which 2 auto-antibodies are created in response to exposure to gluten?

Answer 2

anti tissue transglutaminase (anti-TTG) and anti-endomysial (anti-EMA)

Question 3

what is the histology of coeliac disease?

Answer 3

villous atrophy and crypt hypertrophy, increased intraepithelial lymphocytes and lamina propria infiltration with lymphocytes

Question 4

presentation of coeliac disease?

Answer 4

asymptomatic, failure to thrive, diarrhoea, fatigue, weight loss, mouth ulcers, anaemia secondary to iron and b12 folate deficiency, dermatitis herpetiformis

Question 5

what neurological symptoms can present with coeliac disease?

Answer 5

peripheral neuropathy, cerebellar ataxia, epilepsy

Question 6

genetic associations?

Answer 6

HLA-DQ2 (90%) and HLA DQ8

Question 7

what to do if someone is IgA deficient?

Answer 7

Test for IgG version of anti-TTG or anti-EMA antibodies or endoscopy with biopsy

Question 8

associations with coeliac disease?

Answer 8

t1d, thyroid disease, autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis

Question 9

complications of untreated coeliac?

Answer 9

vitamin deficiency
anaemia
osteoporosis
ulcerative jejunitis
small bowel adenocarcinoma
non-hodgkin lymphoma
enteropathy-associated t cell lymphoma
subfertility
lactose intolerance
hyposplenism

Question 10

treatment of coeliac?

Answer 10

lifelong gluten free diet

Question 11

how is diagnosis of coeliac disease made?

Answer 11

serology (antibodies) and intestinal biopsy

Question 12

functional hyposplenism, wheat vaccine is offered?

Answer 12

pneumococcal and booster every 5 years

Question 13

if testing for coeliac patients must be on gluten diet for how many weeks?

Answer 13

6