Coeliac Disease Flashcards
What is Coeliac Disease?
AUTOIMMUNE Allergy to gluten
Common Disease 1/100 in UK
In which age group is Coeliac Disease commonly presented?
40-60 + female
Which genes are associated with Coeliac Disease?
HLA-B8 and HLA-DQ2
What deficiencies are associated with Coeliac Disease?
B12, folate and iron deficiency
What triggers the immune reaction in Coeliac Disease?
Prolamine proteins e.g. gluten and gliadin
Which grains contain the proteins that trigger Coeliac Disease?
Wheat, barley, rye
What enzyme breaks down gluten and gliadin proteins?
Tissue transglutaminase (TTG)
What type of immune response is triggered by antibodies to TTG?
T-cell mediated immune response
What is the primary consequence of the immune response in Coeliac Disease?
Damage to structure/function of small intestine leading to malabsorption
What are some mild symptoms of Coeliac Disease?
Bloating, Mild abdominal discomfort
What are severe symptoms of Coeliac Disease?
Profuse diarrhoea
Steatorrhoea (fat malabsoprtion)
Weight loss
Abdominal pain
Failure to thrive (children)
What are common examination findings in Coeliac Disease?
Often normal
Signs of B12 deficiency (fatigue, pallor, jaundice, hyperpigmentation, vitiligo)
Signs of anaemia (koilonychia)
Oral aphthous ulceration
What is a rare sign associated with Coeliac Disease?
Dermatitis Herpetiformis (DH)
What blood tests are conducted for Coeliac Disease?
FBC
Low iron/ferritin
Low B12&folate
CPR and WBC raised
What is the specific and sensitive serological test for Coeliac Disease?
Serum anti-Tissue Transglutaminase antibodies (Anti-TTG)
What is required for accurate results in the screening test for Coeliac Disease?
Patient should have gluten in diet for 6 weeks
What can cause a false negative result for anti-TTG antibodies?
IgA deficiency
What is the gold standard for diagnosing Coeliac Disease?
Duodenal biopsy via Upper GI endoscopy while eating gluten
What are the pathological findings in Coeliac Disease?
- Intraepithelial lymphocytosis
- Villous atrophy
- Crypt hyperplasia
What is the primary treatment for Coeliac Disease?
GLUTEN FREE DIET
What are safe foods for individuals with Coeliac Disease?
- Corn (maize)
- Rice
- Potatoes
What vaccination is recommended for patients with Coeliac Disease?
Pneumococcal vaccine (every 5 yrs)
What are complications of uncontrolled Coeliac Disease?
- Osteoporosis
- Hyposplenism
- Increased risk of malignancy
- Lactose intolerance
What type of cancer is associated with Coeliac Disease?
Enteropathy-associated T-cell lymphoma of small intestine
