Coeliac Disease Flashcards
intolerance to what causes coeliac disease
gliadin
- gluten triggers production of IgA antibodies and a T-cell mediated autoimmune process targets the skin and gut
age of onset
any, peaks in infancy and 50-60
histology
flattened villi (atrophy) and a reduced capacity for absorption
what skin rash is it associated with
dermatitis herpetiformis
- itchy
- vescicular
- symmetrical and found on extensor surfaces
- appear in groups/clusters
which type of hypersensitivity reaction is it
IV
which part of the small intestine is most affected
duodenum (first?)
associated with which genes
HLA DQ2 and DQ8
family relative risk?
1st relative - 10-15%
female to male risk?
2:1
symptoms
- diarrhoea
- steatorrhoea, odour
- abdominal pain
- weight loss
- excessive flatulence
- anaemia and vit deficiencies
- aphthous ulcers and angular cheilitis
- weight loss
- fatigue and weakness
reason for steatorrhoea
malabsorption of fats
blood test performed
tTGA
investigations
small bowel biopsy tTGA DEXA bone scan for osteoporosis
cause of osteoporosis in coeliac
chronic malabsorption of Ca
what will small bowel biopsy show you
subtotal villous atrophy and crypt hyperplasia and lots of lymphocytes
treatment
gluten free diet vitamin and mineral replacement
complications
- T cell lymphoma ( - Small bowel carcinoma - Gallstones - Osteoporosis
when would u suspect T cell lymphoma as a complication
refractory symptoms or weight loss
immunology
helper t cel mediated tissue damage following presentation by antigen presenting cells via MHC class II
how do children present
abdominal distension, diarrhoea and failure to thrive
how do a adults present
chronic diarrhoea and bloating
one should suspect coeliac disease in all patients with what
weight loss anaemia and diarrhoea
what is gliadin found in
wheat
rye
barley
(rice, oats, sugar and potatoes are ok)
