Coeliac Disease Flashcards
What is coeliac disease?
An autoimmune condition of the small bowel due to intolerance to wheat
What cells mediate the response?
T-Cells
What is the proper trigger?
PROLAMIN-an alcohol soluble protein found in wheat
What does this result in?
Villous atrophy and malabsoprtion due to loss of bowel surface area
What antibodies are indicated in coeliac?
Anti-tissue transglutaminase
Are there any genetic causes?
Yes, 95% of patients have changes in their HLA DQ2 gene
Any links to other conditions?
Yes, dermatitis Herpetiformis
Is coeliac common?
It affects 1 in 300 people
Who does it affect?
It affects both genders equally, peaks in infancy and 50-60years old. 30% risk for siblings
Symptoms (10)
Steatorrhoea, diarrhoea, abdominal pain, bloating, nausea, vomiting, weight loss, fatigue, weakness, 1/3 may be asymptomatic
Signs (4)
Apthous ulcers, angular stomatitis, osteomalacia, failure to thrive
What bloods would you do? (7)
FBC (low Hb), LFT, U&E, B12 (low), Ferritin (low), Gliadin, Tissue Transglutaminase Antibodies IgA
Other investigations (3)
Duodenal Biopsy, Try gluten free, stool samples (MC&S)
What is the treatment? (2)
Life long gluten free diet, verify diet using anti-endomysial tests
Complications (8)
Anaemia, secondary lactose intolerance, GI T cell lymphoma, increased risk of intestinal cancer, myopathies, neuropathies, hyposplenism, osteoporosis
