Coeliac Disease Flashcards
What is Coeliac disease?
An autoimmune reaction to gliadin which is gluten.
What are the risk factors for CD? Include figures
FH
- Identical twins - 70%
- 1st order relative - 10%
Genetics
- DQ2 and DQ8 HLA type
What is the pathyphysiology of CD?
- Gliaden is broken down by tissue transglutaminase (TTG) which releases immnogenic antigens.
- IgA and IgG are made against these.
- This causes inflammation and villous atrophy.
Which part of the bowel is most commonly affected?
Duodenum
What are the histological findings for CD?
- Villous atrophy
- Increased infllux of immune cells
- Crypt cell hypertrophy
What are the investigations for CD?
Blood - Anti TTG IgA/IgG or endomysial antibodies RAISED
Low IgA
X ray - ?SI distension
Endoscopy and biopsy - Histological findings and inflammation
What are the signs and symptoms of CD?
- Diarrhoea, abdo pain and steatorrhea
- Mouth ulcers, glossitis and angular stomatitis - Anaemia
- Anaemia - low Fe or B12
- FTT
- WL
- Bleeding to due low vit k
- Parasthesia and neurological symptoms due to low vit C
- Dermatitis herpetiformis
What is the management of CD?
Low gluten diet (don’t eliminate due to malabsorption/constipation/malignancy risk)
Correct nutritional deficiencies
?Steroids
?Osteomalacia
What does CD increase the risk of?
GI cancers
other autoimmune diseases
What is latent CD?
Serological findings but no symptoms
What other organ is commonly affected by CD?
Liver
Raised ALT/AST
What is the gold standard for CD?
Biopsy
In general, what blood tests are autoimmune diseases associated with?
Low IgA
What is IgA involved with?
Mucosal defences
Breast milk
