Coeliac disease Flashcards
associations
other autoimmune diseases in adults
prolamin
alcohol soluble proteins in wheat, barley, rye and oats
what is it
T-cell mediated autoimmune disease of small bowel
prolamin intolerance –> villous atrophy, crypt hyperplasia + malab
6 categories for the pathology of malabsorption
- insufficient intake
- defective intraluminal digestion
- insufficient absorptive area
- lack of digestive enzymes
- defective epithelial transport
- lymphatic obstruction
which malabsorption pathology category does coeliac fit into?
insufficient absorptive area
epidemiology
1%
classical presentation
diarrhoea
steatorrhoea
weight loss
failure to thrive
non-classical presentation
IBS-type symptoms iron-deficiency anaemia osteoporosis chronic fatigue ataxia
serology
tTG - tissue transglutaminase
EMA - anti-endomysal antibody
IgG + IgA
keep up the gluten before testing!!
endoscopy + duodenal biopsies
at least 4 duodenal biopsies and 1 duodenal bulb biopsy
histology
villous atrophy and crypt hyperplasia
marsh criteria
normal –> total villous atrophy
Tx
gluten free diet
DEXA scan - osteoporotic risk
Coeliac UK info
complications
anaemia secondary lactose-intolerance GI T-cell lymphoma increased risk of cancer myopathies
tropical sprue
villous atrophy + malab
far + middle east + carribean
cause unknown
