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)


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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Dr Ikram Nasr (Corresponding author)

Gastroenterology Department, Guys and St Thomas' NHS Trust,
Westminster Bridge Road, London, SE1 7EH.

Dr Iman Nasr

Bart's Health NHS Trust, Allergy and Immunology,
Whitechapel Road, London, E1 1BB.

Professor Paul J Ciclitira

Gastroenterology Department, Guys and St Thomas' NHS Trust,
Westminster Bridge Road, London, SE1 7EH.


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T​he 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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