coeliac disease Flashcards
what is the damaging part of gluten
gliadin
why is gliadin damaging
they are resistant to digestion by pepsin and chympotrypsin so remain in the small intestinal lumen, triggering immune responses
once gliadin passes through. epithelium what does it bind to
antigen presenting cells which interact with CD4+ T cells
what do the T cells produce
pro inflammatory cytokines
what do gliadin cells cause the release of
IL-15 from enterocytes
what does IL-15 activate
natural killer cells
what does inflammatory cascade cause
villous atrophy and crypt hyperplasia
what can be an identifier for coeliac disease
anaemia during pregnancy
symptoms
- diarrhoea
- steatorrhoea
- abdominal pain
- weight loss
- mouth ulcers
- infertility
what is gold standard investigation
small bowel biopsy
what is done instead of biopsies with increasing accuracy
serological test
what is most common cause of villous atrophy
coeliac disease
what deficiency do some people have with coeliac disease
IgA
complications
- small bowel adenocarcinoma
- ulcerative jejunitis
- carcinoma of oesophagus
