coeliac disease r Flashcards
pathophysiology of coeliac disease
autoimmune condition where exposure to gluten causes an immune reaction that creates inflammation in the small intestine
risk factors for coeliac
genetics - HLA DQ4, DQ8
other autoimmune conditions
downs syndrome
presentation of coeliac disease
fat belly muscle wasting lethargy growth failure/short stature poor weight gain constipation rash mouth ulcers
what is the rash seen in coeliac disease
dermatitis herpatiformis
what neurological symptoms can coeliac present with
peripheral neuropathy
cerebellar ataxia
epilepsy
investigations for coeliac
! do not remove gluten from the diet when investigating ! coeliac screen duodenal biopsy genetic tests biopsy
what tests does a coeliac screen have
anti-tissue transglutimase
anti-endomysial
IgA
what could a duodenal biopsy show in coeliac disease
oedema
blunting of villi
scalloping
erythematous mucosa
what would a biopsy show in coeliac disease
villous atrophy
increased intra-epithelial lymphocytes
when could you diagnose coeliac without needing to do a biopsy
if there are:
- symptoms
- anti-tissue transglutimase >10x upper limit of normal
- anti-endomysal antibody +ve
- HLA +ve
when should you re-challenge diagnosis and repeat a biopsy
if the child is under 2
another condition like autoimmune enteritis can mimic coeliac
management for coeliac
refer to dieticians
gluten free diet for life
can monitor antibodies
complications of untreated coeliac
vitamin deficiency anaemia osteoporosis ulcerative jejunitis ostopenia small bowel lymphoma non-hodgkin lymphoma
