CELIAC DISEASE

Question 1

What is celiac disease

Answer 1

Inflammation of small intestine in response to ingestion of wheat protein (Gluten)

Question 2

Causes

Answer 2

Genetics (family history of celiac disease)
Autoimmune Thyroid disease
Type 1 diabetes (no insulin)
IgA deficiency
Inflammatory bowel disease (IBD)

Question 3

Clinical manifestations

Answer 3

Diarrhea
Anemia
Weightloss
Abdominal pain
Abdominal discomfort
Bloating
Steatorrhea (fatty stool)
Aphthous ulcers
Atrophic glossitis

Question 4

DIAGNOSIS

Answer 4

1) FULL BLOOD COUNT
check for
Anemia
Infection
2) LFT
3) ELECTROLYTE UREA CREATININE (EUC)
Check for
Electrolyte imbalance
Malabsorption
4) SEROLOGY
To check for autoantibodies
Anti-gliadin
Anti-endomysium
Anti-tTG (tTG is an enzyme for gluten)
5) ENDOSCOPY
Hyperplasia of small intestinal crypt
Villous atrophy
Lymphocytes in lamina propria in S. Intestine

Question 5

MANAGEMENT

Answer 5

GLUTEN FREE DIET
SUPPLEMENTS
For malabsorption

Question 6

What is celiac crisis

Answer 6

Medical emergency presenting with profuse diarrhea, consequent severe dehydration, electrolyte imbalance, and hypoalbuminemia.

Question 7

Treatment of celiac crisis

Answer 7

REHYDRATION
With electrolytes
CORTICOSTEROIDS
Reduce Inflammation & pain

Question 8

Complications

Answer 8

Anemia
Osteoporosis
GI T cell lymphomas
Neuropathy
Dermatitis Herpetiformis
Hyposplenism

Question 9

Differential diagnosis

Answer 9

Crohn’s disease (IBD)
Colitis
IBS
Cow milk sensitivity
GI T cell lymphomas
Whipple’s Disease