Coeliac disease Flashcards Preview

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Flashcards in Coeliac disease Deck (16):
1

What is Coeliac disease?

Gluten sensitive enteropathy
- It is a genetically linked disease that causes damage to the small intestine leading to malnutrition, due to gluten.

2

What is the antigenic target in coeliac disease?

Targets gluten
e.g. Wheat, rye and barley

3

What is the genetic susceptibility in Coeliac disease?

HLADQ2
HLADA8

4

How is the immunopathology in Coeliac disease carried out?

T cell mediated
Inta-epithelial lymphocyte mediates

5

What does coeliac disease lead to?

Malnutrition

6

What does coeliac disease causes pathologically to the gut?

Villous Atrophy
Increase in cellular infiltrate

7

What is the consequence of the villous atrophy?

Reduced surface area
Malabsorption

8

What is the scale used to measure the severity of coeliac disease?

The Modified MARSH score

9

Explain the mechanism and trigger by which coeliac disease occurs?

Gluten peptides active mucosal epithelial cells
The activated cell express MIC molecules (stress response)
IEL cells detect the stress markers
IEL cells bind to the MIC marker and program the cell to induce cell death.

10

Explain the mechanism of coeliac disease that does not involve stress signals?

Gluten peptides naturally do not bind to MHC class 2
Dysfunction transglutaminase modifies the gluten peptides to bind to MHC class 2
Gluten antigen activates specific CD 4 T cells
Activates T cell kills the epithelial cells
The T cells secrete IFN gamma that activates the epithelial cell.

11

How is coeliac disease diagnosed?

Biopsy - gold standard
Serology - testing for IgA anti-tissue transglutaminase autoantibodies.

12

What cell reacts to the transgluatminase enzyme and what does not do?

B cell react to it..
The B cell then produce an enzyme of anti-tTG- antibodies.

13

What are the symtpoms of coeliac disease?

Weight loss - major symptom
Diarrhoea - major symptom
Anaemia - major symptom
Stinking stools
Bloating
Abdominal pain

14

What is the treatment for coeliac disease?

Life long gluten free diet

15

What are complications of Coeliac disease?

Lactose Intolerance
T cell lymphoma

16

What are the long term complications of coeliac disease?

Osteoporosis
Malnutrition
Increased risk of Lymphoma
Infertility