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Coeliac Disease

Coeliac Disease. What is Coeliac disease?. Autoimmune Heightened immunological response to ingested GLUTEN In genetically susceptible people. NICE suggest 1 in 100 people have CD Often co-exists with other conditions Gluten in - WHEAT, RYE, BARLEY

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Coeliac Disease

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  1. Coeliac Disease

  2. What is Coeliac disease? • Autoimmune • Heightened immunological response to ingested GLUTEN • In genetically susceptible people

  3. NICE suggest 1 in 100 people have CD • Often co-exists with other conditions • Gluten in - WHEAT, RYE, BARLEY • Gluten is NOT in oats, rice and maize

  4. Commonest cause of generalised malabsorption in Western Europe • Childhood= commonest presentation • Adults – women (40-50) and men (50-60) • Associated with HLA-B8 and HLA-A1

  5. HIGH RISK GROUPS • 1st degree relative with CD • Autoimmune THYROID disease • Type 1 DM • IBS • Dermatitis herpetiformis • Down’s syndrome

  6. Presentation in children (6m – 2y) • Chronic diarrhoea • Steatorrhoea • Abdominal distention • FTT Frequently - irritable, anorexic

  7. Presentation in adults (60% asymptomatic) • Malaise, weakness, weight loss • Diarrhoea, steatorrhoea, abdo. Distension + pain • Iron and folate deficiency • Skin rashes

  8. Investigations • Haematology – blood film, MCV, clotting • Biochemistry – LFTs, ferritin, Vit. D, Calcium • Immunology - Endomysial antibodies, TTG, IgA • Jejunal biopsy

  9. Diagnosis Refer to Gastroenterologist Confirmed by Jejunal biospy

  10. Management • Gluten-free diet – dietician input • Counselling • Coeliac society • Follow-up – symptoms, bloods, complications

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