Malabsorption- Coeliac Flashcards
1
Q
definition of coeliac
A
state of heighten immunological response to ingested gluten in genetically susceptible individuals
ingestion of gluten stimulates the immune system to attack the small intestine
2
Q
epidemiology
A
onset most common between 4th and 6th decade
gender no difference
presentation at any age
prevelance isnt increasing just diagnosis as most go undiagnosed
- inc screening
3
Q
classification
A
MARSH SCALE 0- normal 1- raised intra epithelial lymphocytes (IEL) 2 - raised IEL and crypt hyperplasia 3a- partial villous atrophy 3b subtotal villous atrophy 3c- total villous atrophy
4
Q
pathology
A
A-gliadin is the toxic part of gluten binds with IgA in the mucosal membrane transcylased to the lamina propria via the HLA DQ2/DQ8 binds to HG and deaminated inc its immunogenicity deaminated gliadin taken up by macrophages releases cytokines stimulates B cells causing villous atrophy/ crypt hyperplasia and ILI reduced SA to absorb nutrients less B12/Folate/iron absorbed = anaemia
5
Q
Risk factors
A
Other autoimmune disease IgA def breast feeding age of intro to diet rotavirus as infant
6
Q
Classical symptoms
A
abdominal pain and distention weight loss nutritional deficiencies diarrhoea fatty stools
