Tutorial title - Intestines - Celiac disease

9 important questions on Tutorial title - Intestines - Celiac disease

What is celiac disease and what causes it?

Celiac disease is an autoimmune destructive disorder sensitive to the protein gliadin in gluten. Causes include:
  • Genetics and environmental (gluten)
  • Presence of other autoimmune diseases (Type I diabetes, autoimmune thyroid disease)

Where is the primary site affected by celiac disease?

The primary site affected by celiac disease is the jejunum.

Describe the macroscopic and microscopic morphology of celiac disease.

  • Macroscopic: Edema of small intestines, inflammatory destruction.
  • Microscopic: Villus atrophy (gradual blunting of villi), crypt hyperplasia.
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What are the local clinical features of celiac disease?

Local clinical features include:
  • Nutritional deficiency
  • Iron deficiency anemia
  • Diarrhea (exudative)
  • Children: failure to thrive

What are the systemic clinical features of celiac disease?

Systemic features include:
  • Blister/ulcers on skin (pruritic)
  • Malnutrition due to access of food and ability to utilize food

At what age do classic symptoms of celiac disease typically present?

Classic symptoms typically present at 6-24 months of age.

What is the treatment approach for celiac disease?

Treatment involves avoiding gluten and is based on treating malnutrition.

What are the classic symptoms of celiac disease?


Classic symptoms include
  • irritability
  • abdominal distension
  • anorexia
  • diarrhea
  • failure to thrive.

Explain the pathophysiology of celiac disease.

  • Gliadin deamidated by tissue transglutaminase interacts with HLA-DQ2, HLA-DQ8 on APCs.
  • Presented to CD4+ T cells.
  • Cytokine release causing tissue damage.
  • Production of AB against tissue transglutaminase, deamidated gliadin.

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