coeliac disease

Question 1

define coeliac disease

Answer 1

• an autoimmune condition where exposure to gluten causes mucosal inflammation of the small bowel and malabsorption

Question 2

describe the pathophysiology behind coeliacs disease?

Answer 2

1. ingest gluten- wheat, barley, rye
2. A - gliadin is the toxic part in gluten
3. it triggers immune system by binding to IgA to make antibodies- anti- ttg and anti - EMA
4. Targets epithelial cells of small intestine causing:
   - villous atrophy
   - crypt hyperplasia
   - intraepithelial lymphocytes

Question 3

what is a tropical sprue?

Answer 3

• malabsorption syndrome
• similar biopsy to coeliac
• treat with antibiotics

Question 4

what is the treatment for coeliacs?

Answer 4

• stop eating gluten
• vitamin + mineral supplements

Question 5

what are the symptoms for coeliacs disease?

Answer 5

1. malabsorption
2. dermatitis herpetiformis
3. osteoporosis
   - low ca2+

Question 6

what are the three types of symptoms of coeliacs disease?

Answer 6

1. malabsorption
2. dermatitis herpetiformis
3. osteoporosis

Question 7

how is coeliacs diagnosed?

Answer 7

1. serology - screening
2. duodenal biopsy- DIAGNOSTIC

Question 8

what does serology show for coeliac disease ?

Answer 8

• anti- tTG
• increased IgA
• increased EMA

Question 9

what does duodenal biopsy show?

Answer 9

• crypt hyperplasia and villous atrophy and epithelial lymphocyte infiltration

Question 10

what are the malabsorption symptoms for coeliacs?

Answer 10

haematinic deficiency - Fe, B12, Folate
- anaemia
- steatorrhoea
- diarrhoea
- weight loss and failure to thrive

Question 11

what are the dermatitis herpetiformis symptoms of coeliacs?

Answer 11

• red raised patches on elbows, knees and buttocks caused by IgA deposition

Question 12

what are the risk factors for coeliacs?

Answer 12

• other autoimmune diseases- T1DM
• IgA deficiency
• breastfeeding
• rotavirus infection
• genetic- HLA DQ2 or HLA DQ8