COELIAC DISEASE CLINICAL MEDICINE, Summaries of Clinical Medicine

Download COELIAC DISEASE CLINICAL MEDICINE and more Summaries Clinical Medicine in PDF only on Docsity! GLUTEN INTOLERANCE OR COELIAC DISEASE by: Mwanangombe Collins. S, MBChB candidate Sunday 9 April 2023 COELIAC DIEASE DEF: Gluten sensitivity enteropathy, immune mediated, malabsorption (inherited) disease, triggered by ingestion of gluten containing food such as wheat, rye, barley and oats etc. PATHOPHYSIOLOGY Once gluten reaches the jejunum, duodenum and ileum, it is digested to amino acids and peptides. Some induce the epithelial cells to express IL-8 provoking proliferation of CD8+ intraepithelial lymphocytes which expresses NKG2D (natural killer cells). These attacks the expressed receptors for MIC-A, simultaneously, after sensitization the APC (antigen presenting cells) stimulate the CD4+ T-cells to produce cytokines responsible for epithelial destruction and mucosal dysfunction. HISTOLOGICAL FEATURES: Intraepithelial CD8+ lymphocytes Villi atrophy, flat and lower columnar to cuboidal appearance Crypts hyperplasia Others in advanced stage, see cells in the upper lamina propria: Infiltrates of basal plasma cells mast cells and Eosinophils DIAGNOSIS: serological and histology combined to increase the specificity. CLINICAL SKILLS (Classical symptoms)