Coeliac Disease

Question 1

What effect does coeliac disease have on FBC?

Answer 1

Decreased iron/ferritin, folate.

B12 not usually affected.

Question 2

What serological tests are useful in coeliac disease?

Answer 2

IgA anti-endomysial AB (>90% s+s)
IgA anti-transglutaminase AB (>90% s+s)
Villous atrophy on BX is confirmatory

IgA antigliadin AB has limited use - ok for screening

Question 3

What basic foods contain gluten?

Answer 3

Wheat, barley, oats and rye.

Question 4

What is the DxT for coeliac disease?

What other features are often present?

What part of GIT is affected?

Answer 4

Diarrhoea, weight loss and fatigue
Osteoporosis/penia (rarely malacia), poor Ca++, vit A,D,E,K abs, iron/folate def, constipation alternating with the diarrhoea, mouth ulcers. Dermatitis herpetiformis - v.itchy purple flexural rash, lymphoma; Proximal (duodenum and jejunum)