Coeliac disease Flashcards
1
Q
What is the definition of coeliac disease?
A
Inflammation of the mucosa of the upper small bowel that improves when gluten is withdrawn from the diet
2
Q
What is the epidemiology of coeliac disease?
A
Up to 1% of the population are affected. 1 in 300-1500
3
Q
What is the pathology of coeliac disease?
A
- Gluten contains gliadin
- Absorbed into epithelial cells
- Gliadin is deactivated in the cell by tissue transglutaminase
- Deactivated gliadin attaches to the antigen presenting cell
- B cells produce antibodies and signal T cells to release cytokines
- = Villous atrophy and crypt hyperplasia
4
Q
What are the risk factors/aetiology of coeliac disease?
A
- Irish
- Family history
- Gluten (prolamins)
- Not being breast fed
- Age of introduction to gluten
- Rotavirus infection in infancy
5
Q
What are the signs/symptoms for coeliac disease?
A
- Diarrhoea
- Stinking stools, steatorrhoea
- Abdominal pain
- Bloating
- Nausea/vomiting
- Aphthous ulcers
- Angular stomatitis
- Weight loss
- Anaemia (esp. ↓ Fe and B12)
- Dermatitis herpetiformis – Blistering skin condition associated with coeliac
6
Q
What investigations are carried out for suspected coeliac disease?
A
- FBC - ↓Hb, ↑MCV, ↑ WBC
- ↓ Fe, ↓ B12
- IgA antibodies
- Endoscopy with biopsy
- DXA scan
7
Q
What are the surgical treatments for coeliac disease?
A
None
8
Q
What are the pharmacological treatments for coeliac disease?
A
• Replacement of minerals and vitamins e.g. Fe, folic acid, Ca, Vit D
9
Q
What are the non pharmacological treatments for coeliac disease?
A
• Gluten free diet
