coeliac disease Flashcards
1
Q
symptoms of coeliac
A
lethargy anaemia (b12,fe & folate) abdominal pain diarrhoea weight loss osteoporosis sub-fertility
2
Q
what is coeliac
A
autoimmune
reaction to gluten damages the villi lining
3
Q
3 categories of coeliac
A
- coeliac
- undiagnosed/ silent (biopsy +, no symptoms)
- latent (serology positive, biopsy negative, no symptoms)
4
Q
5 serology markers of coeliac
A
- anti-tissue transglutaminases (ttg-igg/iga)
- anti-deaminated gliadin (dgp iga/igg)
- anti-gliadin (aga-iga/igg)
- anti-caesin
- anti-endomysial (ema-iga)
5
Q
which marker is most sensitive for coeliac
A
anti-tissue transglutaminase antibody
6
Q
investigations for coelaic
A
- serology
- d2 biopsy
- HLA gene
-gluten challenge
7
Q
coeliac gene asoc.
A
HLA DQ2
8
Q
1st degree relative %
A
5-15%
9
Q
endoscopic appearance of coeliac disease7
A
- villous atrophy
- crypt hyperplasia
- loss of enterocyte height
- lamina propria infiltration with lymphocytes
- increased intra-epithelial lymphocytes
- increased mitotic activity
(scalloping of the mucosa)
10
Q
treatment coeliac disease
A
gluten free diet avoid wheat, rye and barely oats are ok dietician codex alimentarius
11
Q
%effiacacy of gfd
A
70
12
Q
reasons gfd fails
A
non compliant
inadvertent take
another dx
13
Q
diff dx of coeliac
A
pancreatic enzyme insufficiency
autoimmune enteropathy
bacterial overgrowth
14
Q
treatment refractory coeliac disease
A
steroids prednisolone
consider aza
15
Q
symptoms of refractory coeliac
A
unwell weight loss hypoalbuminuria dehydration steatorrhoea
