Labs
preferred initial screening test
IgA anti–tissue transglutaminase antibodies
Name one common vitamin deficiency associated with celiac disease
Vitamin D disease (deficiency of vitamin A, B12, D, E, K, copper, zinc, folic acid, and iron can also occur)
The cornerstone of treatment
implementation of a strict gluten-free diet for life.
Gold standard for diagnosis of celiac disease
upper endoscopy with duodenal biopsy
Type of ingestion needed for celiac disease to develop
gluten
Hematologic lab finding for which celiac disease should be included in the differential
Iron deficiency anemia
Name the skin condition that involves a blistering rash with pathognomonic cutaneous IgA deposits
Dermatitis herpetiformis
Characteristic biopsy finding seen on endoscopy
Villous blunting
Confirmatory test for dermatitis herpetiformis
skin bx
Most common people and age group diagnosed with celiac
women 30-50
Lab that can be used to monitor response to gluten free diet
IgA anti tissue transglutaminase (tTG)
Name 3 autoimmune conditions associated with celiac
Type 1 diabetes, Hashimoto thyroiditis, PBC, PSC, Addison disease
Treatment of dermatitis herpetiformis if there is incomplete response despite gluten free diet
Dapsone
Common cause of refractory disease?
non-adherence
Screening for what bone condition should be performed in patients with celiac disease?
osteoporosis
haplotype expressed in the majority of patients with celiac disease
HLA-DQ2 and 8
Cancer associated with celiac disease
Enteropathy-associated T-cell lymphoma (smaller risk for colon, oropharyngeal, esophageal, pancreatic, and hepatobiliary cancer)
Approximate timeline of abdominal pain versus diarrhea improvement once a patient adheres to a gluten-free diet
Within days for abdominal pain; Within ~4 weeks for diarrhea
Name three foods that can be eaten that are gluten free
Beans, seeds, fresh eggs, fresh meat, fish, poultry, fruits, veggies, dairy products, corn, millet, rice, sorghum, soy, oats, potatoes, rice cakes
Genetic condition that increases risk for hemolysis in the setting of dapsone therapy.
G6PD deficiency
Type of genetic testing that can help rule out the diagnosis of celiac disease if there is biopsy-serology disagreement
HLA-DQ2 and HLA-DQ8 genotyping
Only way to prevent intestinal T-cell lymphoma
Strict adherence to a gluten-free diet
Medication to maintain remission after induction with corticosteroids in pts with type 1 refractory celiac disease
Azathioprine
Most common side effect associated with dapsone therapy.
Methemoglobinemia (hemolytic anemia is acceptable)
Two childhood viral infections that can increase the risk of celiac disease?
Adenovirus and rotavirus