Difference between revisions of "Celiac sprue"

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Celiac sprue (view source)

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==Microscopic==
==Microscopic==
Features:<ref name=Ref_PBoD843>{{Ref PBoD|843}}</ref>
*Enteritis.
**Intraepithelial lymphocytes - '''key feature'''.
**Plasma cells.
**Macrophages.
*Loss of villi - '''important feature'''.
**Normal duodenal biopsy should have 3 good villi.
*Mitosis increased (in the crypts).
Image:
*[http://commons.wikimedia.org/wiki/File:Coeliac_path.jpg Celiac sprue (WC)].
Notes:
*If you see acute inflammatory cells, i.e. neutrophils, consider Giardiasis and other infectious etiologies.
*Biopsy should consist of 2-3 sites.  In children it is important to sample the duodenal cap, as it is the only affected site in ~10% of cases.
===General===
====Etiology====
*Autoimmune.
====Epidemiology====
*Associated with:
**The skin condition ''[[dermatitis herpetiformis]]''.<ref>TN 2007 D22</ref>
***Tx: dapsone.
**IgA deficiency - 10-15X more common in celiac disease vs. healthy controls.<ref name=pmid12414763>{{Cite journal  | last1 = Kumar | first1 = V. | last2 = Jarzabek-Chorzelska | first2 = M. | last3 = Sulej | first3 = J. | last4 = Karnewska | first4 = K. | last5 = Farrell | first5 = T. | last6 = Jablonska | first6 = S. | title = Celiac disease and immunoglobulin a deficiency: how effective are the serological methods of diagnosis? | journal = Clin Diagn Lab Immunol | volume = 9 | issue = 6 | pages = 1295-300 | month = Nov | year = 2002 | doi =  | PMID = 12414763 }}</ref>
**Risk factor for ''gastrointestinal T cell lymphoma'' - known as: ''enteropathy-associated T cell lymphoma'' (EATL).
====Treatment====
*Gluten free diet.
**''Mnemonic'': BROW = barley, rye, oats, wheat.
====Serologic testing====
*Anti-transglutaminase antibody.
**Alternative test: anti-endomysial antibody.
*IgA -- assoc. with celiac sprue.
===Microscopic===
Features:<ref name=Ref_PBoD843>{{Ref PBoD|843}}</ref>
Features:<ref name=Ref_PBoD843>{{Ref PBoD|843}}</ref>
*Enteritis.  
*Enteritis.  
Michael
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