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Wheat
Barley
Rye
" Wasting disease"
W.K. Dicke (1905-1962)
Samuel Gee (1939-1911)
Factors & Diagnosis
1
Symptoms :
- a positive response to a gluten-free diet
- serologic test --> level of IgA antibodies
- a duodenal biopsy
-----> 4 ou 6 specimens
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
Resistance = not normal
Refractory celiac disease :
=> Resistant to a gluten-free diet
Treatment :
=> Steroid medications: prednisolone,
=> Immunosuppressive drugs
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
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
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
- Rare tumor
- Develops from cells of the internal mucosa of the small intestine
- Located in the duodenum
- Endoscopic video-capsule
- Chemotherapy
- 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
- 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
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
-low complaince with gluten-free diet
-poor palatability (32%)
-dinning outside home (17%)
-poor availability of products (11%)
-asymptomatic by screening (11%)
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 ??
Comprehension question :
What is the celiac disease ?
Say what you learned.