Coeliac disease

Condition

• Coeliac disease: an autoimmune condition characterised by chronic inflammation at the small intestinal mucosa caused by gluten 

History

• can present in many different ways e.g. tiredness, change of bowel habits etc
• low threshold of ordering coeliac serology for non specific symptoms e.g. fatigue, depression 
• The following is from NICE guideline, the following presentation warrants coeliac blood test

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Examination

• often normal 

Investigation

• Coeliac serology: IgA tTg, IgA EMA, IgA DGP , IgG tTg
• HLA DQ2 / HLA DQ 8: negative test essentially excludes coeliac disease
• micronutrient levels 

Management

References:

• http://www.racgp.org.au/afp/2014/october/coeliac-disease-where-are-we-in-2014/