Coeliac Disease

Which gluten protein is likely to be the initiator of the immune and inflammatory reaction in Coeliac disease?

Gliadin

What small bowel villi change is seen histologically?

Atrophy

What small bowel crypt change in seen histologically?

Hyperplasia

List 2 serum antibodies important in the diagnosis of Coeliac disease

1) Tissue transglutaminase (tTG)-IgA antibody

2) Endomysial (EMA)-IgA antibody (with concurrent total IgA levels)

Why should total immunoglobulin A (IgA) levels be checked in Coeliac disease?

Exclude IgA deficiency which may give a false negative auto-antibody result

List the 2 haplotypes present in almost all patients with Coeliac disease

1) HLA DR3-DQ2

2) HLA-DR4-DQ8

Approximately what percentage of patients with Coeliac disease have HLA DR3-DQ2 and/or HLA-DR4-DQ8 compared to the general population of most countries?

More than 99%

List 3 elements/vitamins which may be deficient in Coeliac disease

1) Iron

2) Vitamin B12

3) Folate

List 2 endocrine conditions which increase the risk of Coeliac disease

Type 1 diabetes mellitus

2) Autoimmune thyroiditis

Which 2 skin conditions may occur in Coeliac disease?

1) Dermatitis herpetiformis

2) Atopic dermatitis

Which bone condition is a possible complication?

Osteopenia / osteoporosis

Which autoimmune liver disease is associated with Coeliac disease?

Primary biliary cirrhosis (PBC)

List 2 types of malignancy which is increased risk in Coeliac disease?

1) Lymphoma

2) Gastrointestinal cancer – gastric, oesophageal, colorectal

How long should treatment of a gluten-free diet be continued for?

Lifelong

In a gluten-free diet which 3 foods should be avoided?

1) Wheat

2) Rye

3) Barley