Celiac Disease (Sprue)

by Carlo Raj, MD

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    Our topic now brings us to Celiac Sprue. Now Celiac Sprue, extremely marketable in terms of the products that we find everywhere in the US. You go into a grocery store, gluten–free diet or gluten–free products. You walk into a pizzeria, there's gluten free crusts. So obviously here we have an issue where the body is then creating an autoimmune type of status in which now anywhere along the GI tract you might have destruction taking place. Welcome to Celiac disease. In the US, the prevalence is as high as 1 in 200. Diarrhea is not the main symptom in adult, doesn't have to be. Iron deficiency is much more common. Remember that Celiac sprue, you should be thinking about being in the intestine where the lesion is taking place and it can pick and choose as to whatever it wants in terms of what it wants to destroy. It doesn't have to be continuous. Maybe it's destroying the duodenum, maybe might skip over down to the jejunum or maybe perhaps even down to the terminal ileum resulting in B12 deficiency. So malabsorption, it is a big issue with Celiac. Once you start destroying the parts of the intestine, everywhere, at some point in time there is some kind of malabsorption for sure taking place maybe perhaps even Vitamin D. And therefore resulting in osteomalacia in your patient. Associated with: Apart from the intestine and the diarrhea that might be associated and malabsorption, on the skin there's an extra–intestinal manifestation. It looks like herpes but it's not. You call this Dermatitis herpetiformis. What you would expect upon biopsy here would be an Immunoglobulin A. And only reason for that is because, remember the type of immunoglobulin that you have in your GI system is IgA. An increased incidence of small...

    About the Lecture

    The lecture Celiac Disease (Sprue) by Carlo Raj, MD is from the course Small and Large Intestine Diseases.

    Included Quiz Questions

    1. Small bowel lymphoma
    2. Small bowel adenocarcinoma
    3. Small bowel GIST
    4. Small bowel polyp
    5. Small bowel carcinoid
    1. Dermatitis herpetiformis
    2. Steatorrhea
    3. Iron deficiency anemia
    4. Osteomalacia
    5. Pernicious anemia
    1. Anti-endomysial antibodies
    2. Anti-ssb antibodies
    3. Anti-Ro antibodies
    4. Anti-dsDNA antibodies
    5. Anti-centromere antibodies
    1. Complete flattening of villi with intraepithelial lymphocytes
    2. Partial flattening of villi with intraepithelial lymphocytes
    3. Transmural inflammation with crypt abscess
    4. Mucosal inflammation with lymphocyte aggregates
    5. Sloughing of mucosa with many neutrophils
    1. IgA
    2. IgM
    3. IgG
    4. IgE
    5. IgD

    Author of lecture Celiac Disease (Sprue)

     Carlo Raj, MD

    Carlo Raj, MD

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    Role of biopsy?
    By Hamed S. on 09. March 2017 for Celiac Disease (Sprue)

    A superficial talk about an important contributor to malabsorption. I think it would have been good to discuss why we need to assess for the prescence of IgA to begin with. What the role of HLA is in the disease. Moreover, the importance of biopsy as well as the long term complication of celiac disease include osteoprosis, neurological impairment and enteropathy associated T-cell lymphoma.