Coeliac disease

Disease class: Malabsorption syndromes

Also known as 

• Celiac disease

 

Pathophysiology

• Gluten contains a protein called gliadin. 
• When a patient with Coeliac disease ingests gliadin, there is a hypersensitivity reaction.
• This is a Type IV hypersensitivity reaction.
• The bowel is damaged, causing atrophy of villi (villous atrophy).

 

Symptoms

• Diarrhoea
• Steatorrhea
• Weight loss or failure to thrive
• Fatigue 
• Abdominal pain 
• Cramping
• Bloating

 

Signs

• Abdominal distension

 

Complications

• Dermatitis herpetiformis 
• Iron deficiency anaemia 
• Folic acid deficiency
• Vitamin B12 deficiency
• Vitamin K deficiency 
• Selenium deficiency

 

Investigations

• Full blood count
• Anti-Tissue Transglutaminase
• Anti-endomysial (EMA) antibodies 
• Upper GI endoscopy
• Duodenal biopsy 
• Dual-energy X-ray absorptiometry

 

Management

• Dietary: Gluten-free diet