Coeliac disease Flashcards
Main antibodies
IgA anti-tissue transglutaminase (anti-TTG) (main one)
anti-endomysial
anti-gliadin
Pathophysiology
T cell mediated autoimmune response against the gliadin component of gluten
Symptoms / problems seen
GiT upset
Diarrhoea, bloating, stomach pain
Low vit D, iron, ADEK, thiamine, B6, folate, calcium, fat (most absorbed in small intestine after duodenum where the pathology starts)
What HLA subtypes do most people with coeliac disease have?
DQ2/DQ8 - TO EAT OR NOT TWO ATE
Three complications / associated conditions with coeliac disease
Enteropathy associated T cell lymphoma
Autoimmune hepatitis
Dermatitis hepetiformis
What is dermatitis herpetiformis + symptoms + histology
IgA attacks the basement membrane of the skin, causing bullae formation
Itchy, on extensor surfaces of elbows and buttocks
Neutrophil and IgA infiltration
Gold standard test for coeliac disease
Duodenal biopsy
Histology of coeliac disease
Villous atrophy
Autoimmune hepatitis autoantibodies, classified by type of AIH
Anti-SMA, anti-SLA (soluble liver antigen), ANA - type 1
Anti-LKM1 (liver kidney microsomal 1) - type 2
What HLA is associated with autoimmune hepatitis
HLA-DR3 (think of the liver’s portal triad)
Who gets AIH?
Young women/postmenopausal women
Mx of AIH
Immune suppression, then transplant
But immune suppression doesn’t work in 40% of people
Which IgG antibody is associated with dermatitis herpetiformis?
IgA anti-endomysial Ab
