Coeliac Disease Flashcards
What disorder is celiac
Triggered by?
Type of reaction
- Immune disorder
- Inflammatory reaction in small intestine
- Triggered by gluten component of wheat and related cereals
Who does Celiac affect
Any age in genetically predisposed people
Cause of Celiac
- Genetic Link
- First degree relative of patients: 10-15% risk of coeliac
- HLA D3R-DQ2 / DR4-DQ8 – 99% of patients with coeliac have this (compared to 40%
of general population)
Assosicated conditions with celiac
- Type 1 diabetes
- Autoimmune thyroid disease
- IgA deficiency
- Down’s syndrome
Celiac Symptoms
Very non specific
- Headache
-Chronic fatigue
-changes in mood
-neuropathy, encephalopathy
Abdominal bloating and distention
Diarrhoea
Constipation
Nausea/Vom
Weight change (usually loss)
Short stature
Faltering growth in kids
Dermatitis
Atopic dermatitis
Defects in dental enamal
Unexplained lab results:
Persistently elevated lvier enzymes, iron def anaemia, folat/B12 def
Unexplained infertility
Delayed pub
Muscle/joint pain
OSteopenia/osteoporosis
Bine fractucre
Diagnosis based on what
- Blood test:
- Anti-TTG (tissue transglutaminase antibody) IgA (VERY HIGH FOR CELIAC)
- Anti-EMA (endomysial antibody) IgA
- Anti-DGP (deamidated gliadin peptide) IgA
- Must be eating gluten
- Genetic test (HLA) – useful if negative (99% chance you don’t have coeliac). If
positive, doesn’t discriminate. - Biopsy of duodenum at gastroscopy: Gold standard
Pathology findings
- Intra-epithelial lymphocytosis
- Villous blunting
- Crypt hyperplasia
Treatment
Treatment:
* Gluten free
* BROW – Barley, Rye, Oats and Wheat.
Issues with chronic gluten intake when celiac
- Malnutrition: lack of absorption of micronutrients: anaemia, B12 / folate / weight
loss. Poor growth - Osteoporosis (calcium and vitamin D)
- Infertility
- Lactose intolerance – damage of villous brush border
- Malignancy: small bowel lymphoma
- Peripheral neuropathy, ataxia
- Fatigue, headaches
- Hepatitis
Immunology: Process of celiac
Lecture Slide
