Coeliac disease Flashcards
(22 cards)
What is coeliac disease?
Autoimmune condition where the exposure to gluten causes an immune reaction that creates inflammation in the small intestine.
When does coeliac disease usually develop?
Usually develops in early childhood but can start at any age.
What immune reaction is created in coeliac disease?
Autoantibodies are created in response to exposure to gluten.
What do these autoantibodies target?
These autoantibodies target the epithelial cells of the intestine and lead to inflammation.
What are the two antibodies associated with coeliac disease?
Anti-tissue transglutaminase (anti-TTG) and anti-endomysial (anti-EMA).
How do the antibodies correlate with disease activity?
They will rise with more active disease and can disappear with effective treatment.
Where does inflammation primarily affect in coeliac disease?
Inflammation affects the small bowel, particularly the jejunum.
What does inflammation cause in the intestine?
Atrophy of the intestinal villi, leading to malabsorption of nutrients and disease-related symptoms.
How will the patient present with coeliac disease?
Often asymptomatic; may present with failure to thrive, diarrhoea, weight loss, mouth ulcers, anaemia, and dermatitis herpetiformis.
What neurological symptoms can coeliac disease rarely present with?
Peripheral neuropathy, cerebellar ataxia, epilepsy.
What condition is coeliac disease often linked with?
Patients with a new diagnosis of type 1 diabetes are tested for coeliac, even if asymptomatic.
What genetic associations are linked to coeliac disease?
HLA-DQ2 gene and HLA-DQ8 gene.
What autoantibodies are related to coeliac disease?
Tissue transglutaminase antibodies (anti-TTG), endomysial antibodies (EMAs), deaminated gliadin peptides antibodies (anti-DGPs).
What type of antibodies are anti-TTG and anti-EMA?
They are IgA antibodies. Some patients may have an IgA deficiency.
What should be tested if total IgA is low?
Test for the IgG version of the anti-TTG or anti-EMA antibodies or perform an endoscopy with biopsies.
How is a diagnosis of coeliac disease made?
The patient must remain on a diet containing gluten to detect antibodies or inflammation in the bowel.
What must be checked before testing for coeliac specific antibodies?
Check total immunoglobulin A levels to exclude IgA deficiency.
What findings are expected in an endoscopy and intestinal biopsy?
Will show crypt hypertrophy and villous atrophy.
What is coeliac disease associated with?
Type 1 diabetes, thyroid disease, autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, Down’s syndrome.
What are some complications of untreated coeliac disease?
Vitamin deficiency, anaemia, osteoporosis, ulcerative jejunitis, enteropathy-associated T cell lymphoma (EATL), non-hodgkin lymphoma, small bowel adenocarcinoma (rare).
What is the treatment for coeliac disease?
Lifelong gluten-free diet. Relapse will occur if gluten is consumed again.
How can coeliac antibodies be helpful?
Checking coeliac antibodies can be helpful in monitoring the disease.
