What is Celiac Disease?

Celiac Disease
Expression of sulphated GAGs within archival small intestinal biopsies from two patients with coeliac disease during a biopsy challenge series following previous ESPGHAN guidelines.The biopsies shown were taken from the children at initial diagnosis (top row), then on a gluten-free diet (centre row) and finally following gluten challenge (bottom row). The left hand column shows low power views (original magnification ×10) of case 1, and the right hand column high power (x40) views of epithelial staining in case 2. The specimens show decreased epithelial and increased lamina propria sulphated GAG expression in active coeliac disease compared to findings in the same patient on a gluten-free diet. Strong pericellular staining may be seen on aggregated lamina propria mononuclear cells. Similar findings were seen in 3 other cases. Matrix expansion and syncytial aggregation of syndecan-1+ cells underpin villous atrophy in coeliac disease. Salvestrini C, Lucas M, Lionetti P, Torrente F, James S, Phillips AD, Murch SH - PloS one (2014). Not Altered. CC.

Celiac disease is a digestive and autoimmune disorder that can damage your small intestine. Celiac disease can be triggered by a protein called gluten. Gluten is found in grains, like wheat, barley and rye.

What is the Pathology of Celiac Disease?

The pathology of celiac disease is:

-Etiology: The cause of celiac disease is by sensitivity to the gliadin fraction of gluten. In a genetically susceptible person, gluten-sensitive T cells are activated when gluten-derived peptide epitopes are presented.

-Genes involved: HLA-DQA1 and HLA-DQB1 genes.

-Pathogenesis: The sequence of events that lead to celiac disease are: activation of both a cell-mediated T-cell and humoral B-cell immune response resulted from exposure to the glutens. Transglutaminase deamidates gliadin which results in greater proliferative response of gliadin-specific T-cells that lead to mucosal inflammation and further B-cell activation in patients with the disease.

-Histology: The histology associated with celiac disease shows intraepithelial lymphocytosis, lamina propria inflammation and villous atrophy.

How does Celiac Disease Present?

Patients with celiac disease typically in women at any age from infancy well into senior adulthood. The symptoms, features, and clinical findings associated with celiac disease include diarrhea, fatigue, weight loss, bloating and gas, abdominal pain, nausea and vomiting, and constipation.

How is Celiac Disease Diagnosed?

Celiac disease is diagnosed by serology testing looks for antibodies, Genetic testing for human leukocyte antigens, intestinal biopsy.

How is Celiac Disease Treated?

Celiac disease is treated by following a gluten-free diet. 

What is the Prognosis of Celiac Disease?

The prognosis of celiac disease is fair. Overall, people with untreated or unresponsive celiac disease have increased early mortality compared to the general population.

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Last updated on May 26, 2022