Coeliac Disease Flashcards
Coeliac Disease
A state of heightened immunological response to ingested gluten in genetically susceptible people.
Causes damage to the mucosa of the proximal small intestine with subsequent atrophy of the villi and loss of the absorptive surface.
Familial predisposition
Clinical Features
'Classic presentation' = faltering growth, steatorrhoea and abdo distension... uncommon! Diarrhoea Abdo pain Constipation Fatigue Iron or folate deficiency anaemia Amenorrhoea Short stature
Diagnosis
IgA tissue transglutaminase (tTGA)
If positive:
Demonstration of flat mucosa on jejunal biopsy followed by clinical improvement when dietary gluten withdrawn
Third biopsy on gluten challenge to confirm (commonly omitted in children)
Management
MDT care - dietician input
Gluten free diet
Associated with autoimmune disorders (incl. thyroid, pernicious anaemia); increased risk of small bowel malignancy (esp. lymphoma) and osteoporosis so get lifelong follow up to monitor.
Strict gluten-free diet reduces malignancy risk
