Celiac Disease Flashcards
immune disorder that is triggered by an environmental agent (the gliadin component in gluten) in genetically predisposed individuals
celiac disease
Ethnic group primarily affected by celiac disease
northern Europeans
Serologic studies used to confirm the diagnosis of CD
IgA antibodies to gliadin and endomysium
Protein triggered by gluten and that controls gut permeability by prying apart the cells of the intestinal lining
zonulin
Classic presentation of celiac disease
steatorrhea, weight loss, vitamin deficiencies
Seen on small biopsy of patient with celiac disease
villous atrophy
T/F Patients with celiac’s disease show a decreased risk of breast cancer
true
Single preferred test for detection of CD
IgA anti-tissue transglutaminase (TTG)
If there is a high probability of the disease, but the IgA anti-tissue transglutaminase (TTG) comes back negative, what further tests can be ordered?
Total IgA or IgG-deaminated gliadin peptides (DGP)
What is the next step in the work-up in a patient found to have positive serology?
small bowel biopsy
Recommended test for individuals with low pretest probability (purely Chinese, Japanese, and Sub-Saharan African). Is also the most specific test.
IgA endomysial antibody test
What is the next step if the serology is positive but the small bowel biopsy is negative?
the patient can be put on high gluten diet and be rebiopsied after6-12 wks
Individuals who get diarrhea, feel “ILL” and bloated and find if they eliminate gluten from their diet they feel better
gluten sensitivity
presence of what IgA antibody is nearly pathognomonic for CD?
endomysium
Recognized incidentally based upon screening for antibodies. Often have some changes in mucosa of the small bowel. do NOT show clinical symptoms but may complain of fatigue
silent CD
