Coeliac Disease

Other Conditions Associated With Coeliac Disease

• Lymphoma

• Thyroid disease

• T1D

Antibodies Associated With Coeliac Disease

• Anti-tissue transglutaminase antibodies (anti-TTG)

• Anti-endomysial antibodies (anti-EMA)

• Anti-deamidated gliadin peptide antibodies (anti-DGP)

HLA Genotypes Associated With Coeliac Disease

• HLA-DQ2

• HLA-DQ8

Coeliac Disease

• Dermatitis herpetiformis (itchy blister rash affecting knees, elbows and natal cleft)

• Failure to thrive in young children

• Diarrhoea

• Bloating

• Fatigue

• Weight loss

• Mouth ulcers

 

Serological Investigations For Coeliac Disease

• Total IgG levels to exclude IgA deficiency (check IgA to confirm)

• Anti-tissue transglutimase antibodies (anti-TTG)

• Anti-endomysial antibodies (anti-EMA) if in doubt after anti-TTG

Biopsy Findings In Coeliacs

• Crypt hyperplasia

• Villus atrophy

Management of Coeliac Disease

Lifelong gluten-free diet

Management Of Coeliac Dermatitis Herpetiformis

Dapsone to reduce itching

Complications Of Eating Gluten With Coeliac Disease

If someone with coeliac disease continues eating gluten, even in tiny amounts, it can lead to:

• Nutritional deficiencies

• Anaemia

• Osteoporosis

• Hyposplenism (with immunodeficiency, particularly to encapsulated bacteria such as Streptococcus pneumoniae)

• Ulcerative jejunitis

• Enteropathy-associated T-cell lymphoma (EATL)

• Non-Hodgkin lymphoma

• Small bowel adenocarcinoma

Gold Standard Investigation For Coeliac Disease

Duodenal biopsy and gastroscopy

Histological Finding For Coeliac Disease

Howell-jolly bodies (splenic insufficiency causes purple H&E staining)