Is a T-cell- mediated autoimmune genetics illness that targets the small intestine and resolves with removal of glutten. Dx is often missed, the glutten free diet is the only TX but can be highly challenging. The disease has been classified as permanent intolerance to ingested glutten( found in wheat and other grains).
Other names:.
Celiac sprue, nontropical sprue, endemic sprue, glutten enteropathy, glutten sensitive enteropathy and glutten intolerance.
The duodenum is affected first often the jejunum might also involved.
It can manifest at any age, increased incidence in people over 55 and it can be under DX, happens more in women than men but it might be related to healthcare seeking behaviors.
The disease is genetic, if there is a family member with HX of celiac disease it makes it more prone to be having it.
Patho.
3 main factors: environmental, genetics and immunologic.
Enviro= ingestion of gluten a protein found in wheat and related grains, it can be found in a variety of processed foods, including sauces and marinades, processed meat and meat substitutes, soups and candie.
Genetic= genetic predisposition for the disease, inherited HLA-human leukocyte antigen, which are proteins found in most cell of the body, especially WBC.
Immuno= HLA indentifies gluten as a foreign invader and produces antibodies that inflame the cells of the small intestines in an attempt to protect the body.
S/S.
GI- abdominal distention, abdominal pain, acid reflux, diarrhea, constipation, flatulence, hypoglycemia, increased appetite or cravings, lactose intolerance, nausea and vomiting, steatorrhea, unexplained weight loss or gain.
Musculoskeletal- arthralgia, bruising, muscle cramps, osteopenia or osteoporosis, short stature.
Neuro- anger, anxiety, ataxia, ADHD, behavioral disturbances, depression, impaired concentration, irritability or apathy, migraines, peripheral neuropathy, seizures, sleep disturbances, suicidal attempts or thoughts.
