Coeliac Disease Flashcards
0
Q
Pathogenesis of Coeliacs?
A
General unknown cause Confounding Factors: - environmental: gliadin and gluten - immunological: through IgA, anti gliadin, antiendomysial, anti-ttg - genetic: first degree relatives
All cause villous atrophy/damage
1
Q
What is Coeliacs?
A
Gluten sensitive enteropathy
2
Q
Presentation of Coeliacs? What is hallmark of diagnosis?
A
Diarrhoea
Vitamin deficiencies
Kids: FTT, gluteal wasting, ABDO distension
KEY IS IMPROVEMENT WITH GLUTEN FREE DIET
3
Q
Ix?
A
IgA tissue transglutaminase
Anti-endomysial
Endoscopic biopsy
SI biopsy
4
Q
What will small intestinal biopsy show?
A
Increased intraepithelial lymphocytes
Absent/reduced ht of villous = look flat
Increased lymphocytes and plasma cells in lamina propria
5
Q
How do you diagnose Coeliacs?
A
Characteristic histology changes on biopsy
Resolution of Sx and histology with gluten free diet
6
Q
Complications of celiac?
A
Intestinal ulceration
Increased risk of cancers
- intestinal lymphoma
- GI cancers
