Paediatric Gastroenterology Flashcards
(34 cards)
What are some symptoms that can present in coeliac disease in kids?
Diarrhoea, fatigue, weight loss, failure to thrive, abdominal pain, steatorrhoea.
Often asymptomatic
What are some signs of coeliac disease?
Mouth ulcers, anaemia, dermatitis herpetiformis
What does dermatitis herpetiformis look like?
An itchy blistering rash usually seen on the abdomen
Patients first diagnosed with which conditions will also then be tested for coeliac disease?
T1DM and autoimmune thyroid disease
What is the pathophysiology of coeliac disease?
Autoimmune reaction to gliadin protein
T-cell mediated with consequent production of anti-gluten antibodies, anti-tissue transglutaminase and anti-endomysial antibodies, and activation of epithelial lymphocytes. This all results in epithelial cell destruction and Villous atrophy
What is seen on histology in coeliac?
Villous atrophy and crypt hyperplasia
What are some extra-intestinal features of coeliac disease?
Dermatitis herpetiformis, dental enamel hypoplasia, osteoporosis, delayed puberty, iron deficiency anaemia, arthritis, neuro symptoms (epilepsy, peripheral neuropathy, ataxia)
What are some conditions commonly associated with coeliac disease?
Thyroid disease, type 1 diabetes, Down’s syndrome, autoimmune hepatitis
What are some differential diagnoses for coeliac disease in kids?
IBD, cystic fibrosis, post-gastroenteritis, autoimmune enteropathy, eosinophilic enteritis,
What investigations can be done to check for coeliac disease?
Serology: total IgA and anti-TTG levels
Endoscopy with duodenal biopsy
If total IgA levels are seen to be low which other antibody can be measured for coeliac disease?
IgG DGP (deaminated gliadin peptide), IgG EMA, IgG tTG
What is the management of coeliac disease?
Gluten free diet
What are some complications of coeliac disease?
Anaemia, osteoporosis, vitamin deficiency, malignancy, ulcerative jejunitis
What are causes of vomiting in an infant?
GORD, overfeeding, infection, food allergy/intolerance, form of intestinal obstruction, congenital adrenal hyperplasia, renal failure
What is bile stained vomit a reg flag for?
Intestinal obstruction
What is haematemesis a red flag for in a vomiting child?
Oesphagitis, peptic ulceration, oral/nasal bleeding, oesophageal variceal bleeding
What is projectile vomiting a red flag for in a vomiting child?
Pyloric stenosis
What is coughing at the end of paroxysmal coughing a red flag for in a vomiting child?
Whooping cough
What is abdominal distention a red flag for in a vomiting child?
Intestinal obstruction e.g strangulated inguinal hernia, ascites
What is Hepatosplenomegaly a red flag for in a vomiting child?
Chronic liver disease, inborn error of metabolism
What is blood in the stool a red flag for in a vomiting child?
Intussusception, bacterial gastroenteritis, IBD
What is severe dehydration a red flag for in a vomiting child?
Severe gastroenteritis, systemic infection or DKA
What is a bulging fontanelle a red flag for in a vomiting child?
Raised intracranial pressure, Meningitis
who is typically affected by cows milk protein allergy?
formula-fed infants in the first3 months of life
