Coeliac's Disease

Question 1

Repeated exposure to gluten leads to?

Answer 1

Villous atrophy

Question 2

genetic associations with?

Answer 2

HLA-DQ2 and HLA-DQ8

Question 3

features of coeliac disease?

Answer 3

o Suspect if diarrhoea + weight loss and anaemia.
o Chronic or intermittent diarrhoea.
o Failure to thrive or faltering growth.
o Stinking stools/steatorrhoea
o Bloating, recurrent crampy abdominal pain

Question 4

peak incidence ?

Answer 4

childhood and 50-60

Question 5

NICE guidelines that if patients are already taking a gluten free diet then they should do what?

Answer 5

Re-introduce gluten for at least six weeks prior to testing

Question 6

what antibody test is a preferred 1st choice test?

Answer 6

Tissue transglutaminase (TTG)

Question 7

If serology +ve/high likely suspicion of Coeliac’s - what do you do next?

Answer 7

do a duodenal/jejunal biopsy while on gluten diet to see:
o Villous atrophy
o Crypt hyperplasia
o ^^intra-epithelial WBC (lymphocytes)

Question 8

Tx?

Answer 8

Lifelong gluten free diet, get rid of:

• wheat: bread, pasta, pastry
• barley: beer
• rye
• oats

Patients can have rice, potato and corn.