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Coeliac Disease (Pathophysiology (Tissue transglutaminase breaks down…
Coeliac Disease
Pathophysiology
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Cytokines are released, causing mucosal inflammation and villous atrophy
Gliadin enters the small bowel, between the enterocytes due to loose junctions
T cells also stimulate B cells to produce anti-gliadin antibodies, anti-endomysal antibodies and anti-tissue transglutaminase antibodies
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Investigations
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FBC: mild anaemia, folate + iron deficiency
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Patient must be eating gluten every day for 6 weeks before they have any tests to ensure the results are accurate
DEXA scan: performed at diagnosis due to increased risk of osteoporosis - villous atrophy means calcium is not absorbed as well
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Definition
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A state of heightened immunological responsiveness to ingested gluten in genetically susceptive individuals
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Epidemiology
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Increasing prevalence is due to: improvement in endoscopic techniques, antibody screening, increased awareness, actual increase in disease incidence
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Treatment
Can eat rice, maize, soya, oats
Life long gluten free diet - no wheat, rye, barley