Coeliac Disease

Question 1

Aetiologies?

Answer 1

Mutation of certain genes, autoimmune disease, dermatitis

Question 2

Pathology?

Answer 2

Sensitivity to gluten

T-cell mediated destruction of villi in small intestine causing malabsorption

Question 3

Signs and Symptoms?

Answer 3

Diarhoea, Steatorrhoea, Weight loss, Anaemia, Abdominal pain, Bloatedness, Nausea, Vomiting, Mouth ulcers, Fatigue, Weakness, Failure to thrive in infants

Question 4

Investigations and Findings?

Answer 4

Serum IgA antibodies

Endoscopy and biopsy of small intesitine mucosa - vicious atrophy, leucocytosis in epithelium, crypt hyperplasia

Question 5

Management?

Answer 5

Attempt gluten/lactose free diet

If symptoms resolve then this is diagnostic

Question 6

Complications?

Answer 6

Rare - anaemia, malignancy, myopathies