Misc Facts

Question 1

Coeliac disease:

• cause?
• assoc conditions? (2)
• what should be done before testing?
• Diagnosis?

Answer 1

Sensitivity to the protein gluten

Dermatitis herpetiformis (vesicular, pruritic skin condition)
Autoimmune conditions (T1DM, autoimmune hep)

If stopped eating gluten, reintroduce gluten into diet for 6 weeks before test (abnormalities reverse when you stop eating gluten)

Combination of both immunology and duodenal biopsy

Question 2

Immunologic tests for coeliac disease? (4)

Answer 2

anti-TTG IgA antibodies (more sensitive)
anti-endomysial antibodies (more specific)

anti-gliadin IgA/IgG - not recommended by NICE
anti-casein antibodies (found in some patients)

Question 3

What is seen on duodenal biopsy for coeliac disease? (4)

Answer 3

Villous atrophy
Crypt hyperplasia
Increased intraepithelial lymphocytes
Lamina propria infiltration with lymphocytes

Question 4

Drug-induced lupus antibodies?

Answer 4

Anti-histone antibodies

Question 5

What is commonly used to measure severity of pancreatitis?

Answer 5

Hypocalcaemia

Hypercalcaemia can be a cause, hypocalcaemia is indicator of severity