Coeliac Disease Flashcards
What is coeliac disease? Which part of the bowel does it affect?
Coeliac disease is an autoimmune disorder where ingestion of gluten leads to damage in the small intestine.
List 4 symptoms and 1 extra-intestinal symptom of coeliac disease.
- Symptoms: Chronic, intermittent diarrhea, abdominal pain, bloating, weight loss.
- Extra-intestinal symptom: fatigue, dermatitis herpetiformis (itchy, blistery, vescicular skin rash).
Dermatitis Herpetiformis
Inflammatory, immunobullous (caused by antibody mediated reactions), intensely pruritic skin condition characterised by clusters of erythematous, vesicular, and papular lesions.
Diagnosis of dermatitis herpetiformis.
Diagnosis is confirmed through skin biopsy and direct immunofluorescence, and treatment typically involves a gluten-free diet and medication such as dapsone.
Which of the following findings is most characteristic of dermatitis herpetiformis on direct immunofluorescence?
Granular IgA deposition at the dermal papillae.
Which foods are common culprits? When is it therefore worse?
Common culprits include foods containing wheat, barley, and rye. Symptoms worsen after consuming these gluten-containing foods.
When will coeliac disease be suspected in a child/young teen?
If the child has symptoms like chronic diarrhea, abdominal distension, abdominal pain, failure to thrive, weight loss, or delayed puberty.
Which other non-digestive organ may coeliac disease affect?
Coeliac disease can affect the spleen, leading to reduced spleen function (hyposplenism).
What blood tests are used for coeliac disease diagnosis and any specific requirements?
- Total igA,
- TGA (tissue transglutaminase antibodies)
It’s important to be on a gluten-containing diet for accurate results for at least 6 weeks.
Haplotype most commonly associated with coeliac disease.
HLA DQ2.5
Which gene is coeliac disease most commonly linked to?
Coeliac disease is most commonly linked to the HLA-DQ2 and HLA-DQ8 genes.
What are the endoscopy findings in coeliac disease?
Endoscopy may show villous atrophy, crypt hyperplasia, and increased intraepithelial lymphocytes.
What is the management for coeliac disease?
Management involves a strict, lifelong gluten-free diet. Regular follow-up and nutritional support are also important.
Most common complication of coeliac disease
Anaemia: iron, folate and vitamin B12 deficiency (folate deficiency is more common than vitamin B12 deficiency in coeliac disease)
Risk of other auto-immune diseases.
