Coeliac in adults Flashcards
What is coeliac disease?
Autoimmune condition caused by sensitivity to the protein gluten
What is the name of the protein in gluten?
Gliandin
What is coeliac disease associated with?
Family history
HLA-DQ2 allele
Other autoimmune diseases
What alleles is coeliac associated with?
HLA-DQ2
HLA-DQ8
What other autoimmune diseases is coeliac associated with?
Type 1Diabtes mellitus
Autoimmune thyroid disease
Dermatitis herpetiformis
Irritable bowel syndrome
What are the main presenting features of coelaic in adults?
Persistent or unexplained GI symptoms
Prolonged fatigue
Recurrent abdominal pain, cramping
Abdominal distension
Sudden or unexpected weight loss
What are the possible complications of coeliac disease?
anaemia
hyposplenism
osteoporosis, osteomalacia
lactose intolerance
enteropathy-associated T-cell lymphoma of small intestine
subfertility
What forms of anaemia can occur in someone with coeliac disease?
Iron deficiency
Folate deficiency
B12 deficiency
What are the main GI symptoms of coeliac disease?
Abdominal pain
Distension
Nausea and vomiting
Diarrhoea
Steatorrhoea
What bone problems can arise as a result of coeliac?
Osteomalacia
Osteoporosis
What form of cancer is stongly associated with coeliac disease?
Enteropathy-associated T-cell lymphoma of small intestine
How long does someone need to reintroduce gluten into their diet for before they get tested for coeliac?
Reintroduce gluten for at least 6 weeks prior to testing.
What is the first line serological test for coeliac disease?
Tissue transglutaminase (TTG) antibodies (IgA)
What other antibody can be tested for in someone with coeliac?
endomyseal antibody (IgA)
What is the main diagnostic test for coeliac?
Endoscopic intestinal biopsy
Where is the endoscopy done in the small intestine?
Usually in the duodenum but can be done in jejunum
What findings on endoscopy would support coeliac disease?
villous atrophy
crypt hyperplasia
increase in intraepithelial lymphocytes
lamina propria infiltration with lymphocytes
What is the main management of coeliac disease?
Diet excludign gluten
What are gluten containing foods?
Wheat
Rye
Barley
What are some foods that do NOT contain gluten?
rice
potatoes
corn (maize)
What do patients wih coeliac disease have a degree of?
Functional hyposplenism
What do patients with coeliac disease have to get due to the hyposplenism?
Pneumococcal vaccine
every 5 years
