Week 7 (Celiac Disease) Flashcards
What are gluten proteins rich in that makes them poorly digested in the human gastrointestinal tract?
Alcohol-soluble proline and glutamine peptides
These peptides resist degradation by pancreatic and brush border endopeptidases.
What are the classic symptoms of Celiac Disease?
- Diarrhea
- Abdominal Pain
- Bloating
- Weight Loss
The percentages of individuals experiencing these symptoms are 80%, 60%, 73%, and 45% respectively.
How many reported symptoms are associated with Celiac Disease?
Over 250 reported symptoms
This contributes to many cases being undiagnosed.
List some other symptoms of Celiac Disease.
- Anemia
- Anxiety
- Brain fog
- Constipation
- Delayed growth in children
- Depression
- Discolored teeth
- Fatigue
- Headaches
- Infertility
- Irritability
- Rash: Dermatitis Herpetiformis
- Joint Pain
- Liver disease
- Mouth sores
- Osteoporosis
- Neuropathy
- Tingling/Numbness
- Vomiting
- Asymptomatic
What is the genetic predisposition percentage for carrying HLA-DQ2/DQ8 in the population?
Up to 40% of the population
Only about 1% of the population has Celiac Disease (CD).
What are the primary methods of testing for Celiac Disease?
- Serologic Testing
- Histologic testing
Serologic tests include Tissue Transglutaminase IgA, Anti-Endomysial Antibody IgA, and Anti-Deaminated Gliaden Peptide IgG (IgA).
What should be done while testing for Celiac Disease?
All testing should be done while eating gluten
Who wrote the first medical description of Celiac Disease and when?
Aretaeus of Cappadocia in 101–200 AD
He referred to it as ‘The Coeliac Affection.’
What dietary hypothesis was made by Dr. Samuel Gee regarding Celiac Disease?
It can be treated through diet
What did Dr. Willem Dicke theorize in the 1940s about Celiac Disease?
Wheat is triggering Celiac Disease
He developed a wheat-free diet to treat Celiac Disease patients.
In which decades was Celiac Disease recognized as an autoimmune disease?
1970s-1990s
Fill in the blank: Approximately ___% of patients with celiac disease have immunoglobulin A (IgA) deficiency.
2-3%
What is the prevalence of IgA deficiency in the general population?
About 0.2-0.5%
What is the significance of the HLA-DQ2 or HLA-DQ8 in relation to Celiac Disease?
They are genetic markers associated with Celiac Disease
How to test for Celiac disease?
Screen with Serology
- TTG IgA, IgA levels
Confirm with Histology
- EGD with duodenal biopsies
What cannot be confirmed by genetic testing in celiac disease?
Celiac disease
Genetic testing can indicate risk but cannot confirm the diagnosis.
What percentage of the population carries HLA-DQ2 or HLA-DQ8?
30-40%
These are genetic markers associated with celiac disease.
What is the negative predictive value of genetic testing for celiac disease?
Near 100%
If HLA-DQ2 and DQ8 are negative, the patient does not have celiac disease.
What is the primary treatment for celiac disease?
A life-long gluten free diet
This involves avoiding wheat, rye, and barley.
List three foods that must be avoided in a gluten-free diet.
- Wheat
- Rye
- Barley
Other hidden sources include soy sauce, beer, and some processed foods.
Who should patients with celiac disease consult to avoid hidden gluten?
An expert dietician
They can help identify gluten in various food products.
What nutritional deficiencies should patients with celiac disease be screened for?
- Vitamins A, D, E, B12
- Copper
- Zinc
- Folic acid
- Ferritin
- Iron studies
- Magnesium
- Phosphorus
These deficiencies can occur due to malabsorption.
How soon do symptom improvements typically occur after starting a gluten-free diet?
Within days or weeks
Improvement often precedes normalization of serological markers.
How often should celiac-specific autoantibody levels be measured after starting a gluten-free diet?
Every 6-12 months
This continues until the levels normalize.
