Coeliac Disease

Question 1

duodenum structure

Answer 1

scalloping of folds in duodenum and ‘cracked mud’ appearance of mucosa
villi are atrophied and have intraepithelia lymphocytes

Question 2

mechanism of reaction

Answer 2

reaction to glandin in wheat
stimulates membrane cells, enterocytes of intestine to allow larger molecules around the sealant between cells
a glandin fragment stimulates an immune response with release of inflammatory cytokines
peptides are taken up by antigen-presenting cells and resented to CD4+T cell, which secrete proinflammatory cytokines and trigger b-cell response to produce antibodies against peptides

Question 3

symptoms

Answer 3

lethargy, GI symptoms, anaemia

Question 4

risks if undiagnosed

Answer 4

infertility, abortion, low birth weight, fracture risk, anaemia

Question 5

blood tests needed for

Answer 5

ferritin, folic acid, b12, ca2+, thyroid funtion, osteopenia, osteoporosis

Question 6

what is refactory coeliac disease

Answer 6

persistent malabsorption symptoms and villous atrophy despite GF diet for 6-12 months
specialist intervention needed and oids usually recommended

Question 7

what is dermatitis herpetiformis

Answer 7

chronic blistering of skin containing watery fluid

Question 8

common manifestations of coeliac

Answer 8

neuropathy pain, tingling/numbness in feet, ataxia