coeliac disease Flashcards
how does normal intestinal absorption work
pancreas secretes digestive enzymesliver secretes bile acids large surface area - mucosal folds/villi/microvilli brush border enzymes
symptoms of malabsorption
weight loss failure to thrive abdominal distension diarrhoea
causes of malabsorption
west- coeliac disease developing - parasites/worm infections
what is coeliac disease
autoimmune disease of the small bowel characterised by- atrophy of SMI villi - malabsorption due to damaged SI - clinical/histological improvement on gluten withdrawal from diet
epidemiology of coeliac disease
15% diagnosed F>M1/100diagnosed mostly in first 8-12m or 3-4th decades
aetiology of coeliac disease
genetics consumption of gluten proteins
how do genetics play a role in coeliac disease
> 95% of patients have HLA-DQ2/DQ8causes gliadin peptides to bind more tightly = autoimmune response
pathophysiology of coeliac disease
proteins incompletely digested peptides are immunogenic prolamins are absorbed via SI and presented via APC in laminar propria
what are prolamins
alcohol soluble gluten fractions
which foods produce prolamins once digested
glandins in wheat hordeins in barley secalins in rye advins in oats
common symptoms of coeliac disease
diarrhoea fatigue abdomen pain weight loss flatulence
uncommon symptoms of coeliac disease
osteoporosis abnormal liver function iron anaemia constipation nausea dermatitis herpetiformis
what is dermatitis herpetiformis
chronic skin rash of itchy fluid filled blisters - on limbs, trunk and scalp (can be accompanied by intestinal damage
how to treat dermatitis herpetiformis
gluten free diet and dapsone (antimycobacterial)
how is coeliac disease diagnosed
on symptoms serological tests - tissue transglutimase endoscopy biopsy to confirm
