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Celiac disease

INTRODUCTION

Wheat

Barley

Rye

History

" Wasting disease"

  • AD = apres JC

Researchers

W.K. Dicke (1905-1962)

Samuel Gee (1939-1911)

  • lining = paroi
  • Groundbreaking = revolutionary

SUMMARY

  • 1) Factors & Diagnostic

  • 2) Treatments & Take care

  • 3) Complications & Severe cases

  • 4) Conclusion & Quality life

Factors & Diagnostic

Factors & Diagnosis

1

1

Factors

Environmental and genetic factors :

  • Presence of HLA-DQ2 or HLA-DQ8 gene

  • protective effect of breast-feeding for a 4 month old infant
  • minimize risks

Diagnosis

Symptoms :

  • Not specific
  • Malabsorption syndrome
  • Still not reliable

Diagnosis :

  • 3 steps :

- a positive response to a gluten-free diet

- serologic test --> level of IgA antibodies

- a duodenal biopsy

-----> 4 ou 6 specimens

Treatments and clinical management

2

Treatments and clinical management

Treatments

Treatments :

2) treatment : vaccination

=> Coeliac disease can affect the spleen

=> 3 types of vaccines

1) Effective treatment : strict gluten-free diet

=> Manage intestinal symptomes

=> Promote intestinal healing

=> The healing process can take anywhere from

a few weeks to several years

=> Exclude natural or processed foods containing

wheat-derived products

=> Consume foods that are fresh, minimally

processed, and substitutes made from flour

alternatives

=> vitamin deficiency : supplements

Flu Vaccin

Pneumococcal vaccine

Vaccin Hib/MenC

Complications of the disease and its treatment :

Resistance = not normal

Refractory celiac disease :

=> Resistant to a gluten-free diet

Treatment :

=> Steroid medications: prednisolone,

=> Immunosuppressive drugs

Inconvenients

Inconvenients :

70% of people for whom it doesn't work :

70%

30%

1) Barrier 1 :

=> Non-compliance with the diet

> Keep eating gluten

=> gluten is hidden in many products

=> medications with traces of gluten

Doesn't work

Works

COMPLICATIONS CONSEQUENCES :

=> osteoporosis

=> certain types of cancer

2) Barrier 2 :

=> the price of gluten-free foods

Cinical management

Clinical management :

general practitioner

1) Managed by a healthcare team :

A qualified dietitian :

=> in children :continuous evaluation is necessary

- a gastroenterologist for adults

- a pediatric gastroenterologist for children

2) Support group :

Intro

The adenocarcinoma of the small intestine

Complications and severe cases

3.

3

Complications and severe cases

Intro

Poeple affected by severe complications :

- Poeple who continue to eat gluten

- Poeple who have not yet been diagnosed

The potentiel long-term complications :

- intestinal adenocarcinoma

- enteropathyassociated T-cell lymphoma

- refractory sprue

The adenocarcinoma of the small intestine

- Rare tumor

- Develops from cells of the internal mucosa of the small intestine

- Located in the duodenum

- Endoscopic video-capsule

- Chemotherapy

Enteropathy-associated T-cell lymphoma

Enteropathy-associated T-cell lymphoma

- Tumor of the intestinal lymphatic system

- Develops in the duodenum or the ileum

- Chemotheraphy and stem cell transplantation

Symptoms :

anorexia, diarrhea, weight loss, malaise, abdominal pain and fever

Refractory celiac disease

- Concerns patients who are following the diet but the disease remains fully active

- Video-capsule endoscopy, radiology,

- Nutritial support, vitamins and minerals and immunosuppressive drugs

- ulcerative jejunitis

Refractory celiac disease

Conclusion and quality of life

4

Quality of life

Conclusion and quality life

summary

so let's summarize !

-Gluten is not just into food but also in different products

It's very difficult to diagnose:

- often patients are asymptomatic

-looks like many other diseases

the 2 principal anti-bodies that cause inflammation of épithelial cell in the jujenum:

-anti-tissue transglutaminase (ant-ttg)

-anti-endomysial (ant-ema)

they are related to disease activity,

rise or fall depending on the activity

lifestyle

consequences

-low complaince with gluten-free diet

-poor palatability (32%)

-dinning outside home (17%)

-poor availability of products (11%)

-asymptomatic by screening (11%)

What to improve quality life of these patients ?

psychological aspect

psychological aspect

psychological aspect

Rules :

1) make 5 groups

2) Deal 3 cards per group

3) Take 5 minutes to invent sentences

4) Guess the cards in front of the class

=> Wich group will be the best ??

GAME !

List

  • Villous atrophy
  • Small intestine
  • Dietitian
  • Gluten
  • Vitamine deficiencies
  • Cancer
  • Physician
  • Bloating
  • Vaccination and Gluten free diet
  • Deficiency
  • Diet
  • Healing
  • Videocapsule - endoscopy
  • Oats
  • Autoimmune disease

Comprehension question :

What is the celiac disease ?

Say what you learned.

Bonus

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