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5 Cards in this Set
- Front
- Back
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What is coeliac disease? |
Small bowel disorder - Mucosal inflammation, Villous atrophy and crypt hyperplasia occurs upon exposure to gluten diet and demonstrate improvement after withrawal of gluten from the diet |
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Describe signs of coeliac disease? 1. Gastgrointestinal symptoms 2. Extraintestinsal symptoms/ signs |
1. chronic or recurrent diarrhoea/ constipation, malabsorption, unexpected weight loss, abdominal pain/ bloating, distension 2. Iron deficiency, Vit B12 deficiency, Persistent elevation in serum aminotransferase (AST), Dermatitis Herpetiform, Fatigue, recurrent fetal loss, low birth weight offspring, persistent aohthous stomatitis, metabolic bone disease and premature osteoporosis |
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What blood test should you do if you are suspecting coeliac disease? |
1. FBE, Iron study, Vit B12/Folate, AST 2. TTG (Tissue transglutaminase) - IgA + Total IgA - due to false negative IgA-TTG in IgA deficiency (common in Coeliac) - Can add IgG-DGP (Deaminated gliadin peptie) at the same time for IgA deficiency (or another blood test can be done if shown to be IgA deficiency) 3. Other Antibody tests are 1) Autoantibodies - Anti-endomysial antibody (EMA-IgA) - Anti-tissue transglutaminase antibody (TTG-IgA, TTG-IgG) 2) Antibodies targeting gliadin - Antibody to native gliadin: AGA-IgA, AGA-IgG - Antibody against synthetic DGP: DGP-IgA, DGP-IgG |
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Moderate/ high risk factors for coeliac disease are? |
1. First- or Second-degree family member with coeliac disease? 2. Type I DM 3. Autoimmune thyroiditis 4. Down or Turner syndrome 5. Pulmonary Hemosiderosis Patient with gatro-/ extraintestinal symptoms + above risk factors --> Serology test +/- Upper endoscopy with duodenal biopsy |
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What is diagnostic methods for coeliac disease? |
1. Serology test: TTG-IgA/ Total IgA/ DGP-IgG 2. Upper endoscopy + Duodenal biopsy 3. HLA DQ2/DQ8 - All coeliac disease pt are positive; therefore, neative exclude coeliac disease. Test should be done while pt on gluten diet |
