Coeliac Disease Flashcards

1
Q

How can IgA deficiency alter coeliac screen results?

A

Anti-TTG and anti-EMA Abs are IgA. Therefore someone with an IgA deficiency will have a negative coeliac test even when they have coeliacs.

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2
Q

Which conditions are associated with coeliac disease?

A

T1D, thyroid disease, autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis.

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3
Q

Does a gluten-free diet reverse the histological and serological markers of coeliac disease?

A

Yes

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4
Q

Define coeliac disease

A

An autoimmune condition where gluten exposure causes inflammation of the small bowel.

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5
Q

Is coeliac disease more common in males or females?

A

Females

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6
Q

What is the prevalence of coeliac disease in the UK?

A

1%

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7
Q

Which specific gluten protein are patients intolerant to in coeliac disease?

A

Gliadin

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8
Q

Why does malabsorption occur in coeliac disease?

A

Due to inflammation and intestinal atrophy —> reduce absorptive SA.

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9
Q

Which genes are associated with coeliac disease?

A

HLA-DQ2 and HLA-DQ8.

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10
Q

Th cell activation leads to what?

A

Pro-inflammatory cytokine release and B cell activation.

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11
Q

Name the auto-Abs associated with coeliac disease

A

Anti-tissue transglutaminase (anti-TTG) and anti-endomysial (anti-EMA).

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12
Q

Which part of the small bowel is primarily affected in coeliac disease?

A

Jejunum

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13
Q

What are the 3 classical histological features of coeliac disease?

A

Villous atrophy, crypt hyperplasia and lymphocyte infiltration.

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14
Q

Why is there a low threshold for testing for coeliac disease?

A

Because it is often asymptomatic or the symptoms can vary

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15
Q

Describe the clinical features of coeliac disease

A

FFT (children), diarrhoea, weight loss, abdominal pain, bloating, steatorrhoea, fatigue, mouth ulcers, anaemia, dermatitis herpetiformis, ecchymosis, neurological symptoms (neuropathy, ataxia, epilepsy).

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16
Q

Describe the investigations you would carry out in an individual with suspected coeliac disease

A

Check total IgA levels, anti-TTG, anti-EMA, endoscopy and biopsy.

17
Q

What is the management for coeliac disease?

A

Gluten-free diet

18
Q

Describe the complications associated with untreated coeliac disease

A

Vitamin deficiency, anaemia, osteoporosis, ulcerative jejunitis, enteropathy-associated T-cell lymphoma (EATL), non-Hodgkin lymphoma, small bowel carcinoma (rare).

19
Q

Which vaccine is recommended for coeliac disease?

A

Pneumococcal vaccine - due to hyposplenism.