Coeliac Disease Flashcards
Description: What is coeliac disease?
Inflammation in the lining of the small intestine due to sensitivity to Gliadin fraction of Gluten
Aetiology/ Risk Factors:
(a) What is the cause of coeliac disease? (1)
(b) What conditions are associated with coeliac disease? (8)
(a) Cause:
- Sensitivity to Gliadin fraction of Gluten
(b) Associated conditions:
- Dermatitis herpetiformis
- Type I diabetes mellitus
- Autoimmune gastritis
- Autoimmune thyroid disease
- Autoimmune hepatitis
- Primary biliary cholangitis
- IgA deficiency
- Down’s syndrome
Pathology: Describe the pathology of coeliac disease. (3)
- Produces an inflammatory response (via tissue transglutaminase) when exposed to gliadin fraction of gluten
- Partial, subtotal or total villous atrophy
- Increased intra-epithelial lymphocytes (T cell response to gluten)
Symptoms: State the symptoms of coeliac disease. (6)
- Diarrhoea/ steatorrhoea (due to fat malabsorption)
- Abdominal pain
- Abdominal bloating
- Weight loss
- Fatigue (malabsorption leads to iron deficiency anaemia which leads to fatigue)
Signs: What are the signs of coeliac disease? (2)
- Clubbing
- Aphthous ulceration
Investigations: AAA
AAA
Treatment: How do we treat coeliac disease?
- Withdraw Gluten from the diet
- Refer to a state registered dietitian
Complications: What are the complications associated with coeliac disease?
- Refractory coeliac disease
- Oesophageal carcinoma
- Small bowel adenocarcinoma
- Small bowel lymphoma
- Colon cancer
Extra: State the cutaneous manifestation of coeliac disease (1) and what does this cause? (2)
Dermatitis herpetiformis
This causes:
- Blistering on the scalp, elbows, knees and shoulders
- Extremely itchy skin (IgA deposits)
Extra: Why does most damage in coeliac disease occur in the duodenum?
The duodenum is where most damage occurs because it is the first region of the small intestine exposed to gluten hence the need to do a duodenal biopsy
