COELIAC DISEASE Flashcards
Who is at risk of coeliac disease
type 1 diabetics
down sydnrome
turner syndrome
What is coeliac disease
chronic autoimmune disorder of small intestine occurs in genetically predisposed individuals who consume gluten containing food
What are some signs and symptoms of coeliac disease
chronic or intermittent diarrhoea
failure to thrive/faltering growth
persistent/unexplained gastrointestinal symptoms
prolonged fatigue
recurrent abdominal pain, cramping or distension
sudden or unexpected weight loss
unexplained iron deficiency aneamia
What conditions mean that a person should be screened for coeliac disease
-autoimmune thyroid disease
- dermatitis herpetiformis
-IBS
-Type 1 diabetes
-first degree relatives with coeliac disease
What can coeliac disease lead to
malabsorption of nutrients and increased risk of certain cancers
What is a skin manifestation of coeliac disease
dermatitis herpetiformis - presents as pruritic vesicles on elbows, knees and buttocks
What antibodies are coeliac disease associated with
HLA-DQ2
HLA-DQ8
What would be see upon physical examination of someone with coeliac disease
signs of malnutrition such as muscle wasting , dermatitis herpetiformis or aphthous ulcers in mouth
What is first line of investigation
Serologic testing for tissue transglutaminase antibodies - HAVE TO TEST FOR IgA as well.
If tTG-IgA is positive then further testing for endomysial antibodies is performed to confirm diagnosis
small bowel biopsy is gold standard - look at characteristic histological changes–
such as villous atrophy , crypt hyperplasia and lymphocyte infiltration
Blood tests can show malabsorption - low iron, folate and vitamin B12
What is the management
Lifelong gluten free diet
vitamin and mineral supplementation may be necessary to correct any deficiencies
monitoring for complications
What are some complications associated with coeliac disease
anaemia - iron,folate and B12 deficiency
hyposplenism
osteoporosis , osteomalacia
lactose intolerance
enteropathy associated T cell lymphoma of small intestine
subfertility,
rare – malignancies
