Coeliac disease

Key points

Prevalence 1:100 in UK

Immune reaction to gliadin fraction of gluten

Both genetic and environmental risk factors

90% have HLA-DQ2 postive

Associations

Type 1 diabetes

Thyroid disease

Trisomy 21

Turners

History and Examination

Unexplained faltering growth

Abdominal pain

Anaemia

Weight loss

Mouth ulcers

Dermatitis herpetiformis

Cerebellar ataxia

Peripheral neuropathy

Investigations

Haematinics for Iron/B12/Folate deficiencies

IgA

Anti-Tissue transglutaminase (anti-TTG) antibodies

Endomysial antibodies

Biopsies often not necessary in children - but if needed, patient should not yet be on gluten free diet

Histology

Subtotal villous atrophy

Crypt hyperplasia

These features should resolve after being on gluten free diet

References

https://patient.info/doctor/coeliac-disease-pro