Clinical Case Database / Category: Patient Management
Coeliac disease
Publication details
Dr Ikram Nasr, Dr Iman Nasr, Professor Paul J Ciclitira
Foundation Years Journal, volume 9, issue 2, p.26 (123Doc Education, London, February 2015)
Abstract
Coeliac disease (CD) is a chronic systemic, autoimmune disorder in genetically predisposed individuals triggered by exposure to dietary gluten. Gluten ingestion leads to mucosal inflammation, crypt hyperplasia and villous atrophy. Patients may present with many or no gastrointestinal symptoms and or the consequences of malabsorption including iron deficiency anaemia and osteoporosis. Gluten proteins and related prolamins found in wheat, barley, and rye may trigger autoimmune injury to the gut, skin, liver, joints, uterus, and other organs (1). Histological abnormalities including villous atrophy in small bowel biopsies, is considered the gold standard for diagnosis, and supported by serology. Untreated CD is associated with significant morbidity and an up to 4-fold increase in risk of death. The condition is potentially reversible on a gluten free diet.
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Authors
Dr Ikram Nasr (Corresponding author)
Gastroenterology Department, Guys and St Thomas' NHS Trust,
Westminster Bridge Road, London, SE1 7EH.
ikramnasr@hotmail.com
Dr Iman Nasr
Bart's Health NHS Trust, Allergy and Immunology,
Whitechapel Road, London, E1 1BB.
drimannasr@gmail.com
Professor Paul J Ciclitira
Gastroenterology Department, Guys and St Thomas' NHS Trust,
Westminster Bridge Road, London, SE1 7EH.
gastropjc@gmail.com
References
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3. Shadi Rashtak, and Joseph A. Murray. Celiac Disease in the Elderly. Gastroenterology Clinics of North America, September 2009. Volume 38, Issue 3, Pages 433-446.
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6. Saqib Javed, Asimah Safdar, Allan Forster, Arul Selvan, David Chadwick, Andy Nicholson, Anu Jacob. Refractory coeliac disease associated with late onset epilepsy, ataxia, tremor and progressive myoclonus with giant cortical evoked potentials—A case report and review of literature. Seizure. July 2012(21):482–485.
7. Corazza GR, Villanacci V, Zambelli C, Milione M, Luinetti O, Vindigni C, Chioda C, Albarello L, Bartolini D, Donato F. Comparison of the interobserver reproducibility with different histologic criteria used in celiac disease. Clin Gastroenterol Hepatol. July 2007;5(7):838-43.
8. Ludvigssonn JF, Bai JC, Biagi F, et al. Diagnosis and management of adult coeliac disease: guidelines from the British Society of Gastroenterology. Gut 2014:63:1210-1226.
9. Robert ME. Gluten sensitive enteropathy and other causes of small intestinal lymphocytosis. Semin Diagn Pathol. November 2005;22(4):284-94.
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The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
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