lunes, 5 de noviembre de 2018

Coeliac Disease Diagnosis

Coeliac Disease Diagnosis


Coeliac Disease Diagnosis

Celiac disease involves inflammation and damage caused to the inner lining of the small intestines due to an autoimmune process.

Classification of celiac disease

  • Classical celiac disease – this has predominant gastrointestinal symptoms.
  • Atypical celiac disease – this has mostly non-gastrointestinal symptoms and symptoms if present may be single or less in severity.
  • Silent celiac disease with no symptoms

Differential diagnosis

Some of the diseases that need to be ruled out while making a diagnosis of celiac disease include:-
  • Tropical sprue, collagenous sprue and refractory sprue
  • Enteropathy caused by HIV/AIDS or due to combined immunodeficiency or due to autoimmune enteropathy
  • Damage to the intestines due to radiation and/or chemotherapy
  • Graft-versus-host disease after an organ transplant
  • Chronic ischemia of the gut
  • Giardiasis
  • Inflammatory bowel disease like Crohn’s disease
  • Eosinophilic gastroenteritis
  • Zollinger–Ellison syndrome
  • Enteropathy-associated T-cell lymphoma

Diagnostic pathway for detecting celiac disease

Suggested diagnostic pathway for detecting celiac disease includes:–
  • Detailed history of symptoms and family history of a similar condition. First degree relatives of a patient are more likely to get this condition.
  • Physical examination including a detailed general survey examining for signs of poor nutrition and anemia
  • Definitive diagnosis is made on the basis of positive serological tests and endoscopy with biopsy of the lesions in the small intestine.
  • Serological tests include tests that detect serum antibodies. These are basically classified into two groups based on the target antigens. One group is the Anti-tTG antibody tests and the other is Antigliadin antibody tests. Enzyme-linked immunosorbent assay (ELISA) tests are commonly applied.
    The common tests applied are –
    • IgA endomysial antibody (IgA EMA) - this test is most specific and sensitive and gives the highest diagnostic accuracy. These antibodies normally bind to the endomysium that is the connective tissue around smooth muscle. The test result is reported simply as positive or negative and if positive is strongly indicative of celiac disease.
    • IgA tissue transglutaminase antibody or the IgA tTG - the antigen against which the antiendomysial antibodies are directed is tTG. Thus Anti-tTG antibodies are highly sensitive and specific for the diagnosis of celiac disease.
    • IgA antigliadin antibody or the IgA AGA - Gliadins are the major proteins that are present in wheat and are called gluten. Serum antigliadin antibody levels are commonly increased in untreated celiac disease.
    • IgG antigliadin antibody or the IgG AGA
  • Endoscopy with biopsy of the small intestine lesions. The typical findings seen on endoscopy include:-
  • Scalloped folds, fissures and a mosaic pattern
  • Smaller size and or disappearing of folds with maximum insufflation
  • Flattened folds of the inner walls of the small intestines

Intestinal biopsy

Once these abnormalities are detected, an intestinal biopsy is recommended. More than one biopsy is taken from the second or third part of the duodenum. Best samples are obtained with the suction biopsy using a Crosby capsule.
Once the biopsy is mounted on a slide it shows definitive findings under the microscope. The mucosa of the proximal small intestine is affected and the damage shows decreasing intensity towards the distal small intestine.
In more severe cases the damage may extend up to the ileum. In silent cases or asymptomatic cases the damage is mild.

Further Reading

Last Updated: Aug 23, 2018

2 comentarios:

  1. I am bold enough among many others to state that there is now a potent cure to this sickness but many are unaware of it. I discovered that I was infected with the virus 3 months ago, after a medical check-up. My doctor told me and I was shocked, confused and felt like my world has crumbled. I was dying slowly due to the announcement of my medical practitioner but he assured me that I could leave a normal life if I took my medications (as there was no medically known cure to Herpes). I went from churches to churches but soon found that my case needed urgent attention as I was growing lean due to fear of dying anytime soon. In a bid to look for a lasting solution to my predicament, I sought for solutions from the herbal world. I went online and searched for every powerful trado-medical practitioner that I could severe, cos I heard that the African Herbs had a cure to the Herpes syndrome. It was after a little time searching the web that I came across one Dr Itua(A powerful African Herbal Doctor), who offered to help me at a monetary fee. I had to comply as this was my final bus-stop to receiving a perfect healing. My last resolve was to take my life by myself, should this plan fail. At last it worked out well. He gave me some steps to follow and I meticulously carried out all his instructions. Last month, to be precise, I went back to the hospital to conduct another test and to my amazement, the results showed that negative,Dr Itua Can As Well Cure The Following Desease…Cancer,Hiv,Herpes,Shingles, Hepatitis B,Liver Inflammatory,Diabetis,Fribroid,Parkinson's,Alzheimer’s disease,Bechet’s disease,Crohn’s disease
    ,Cushing’s disease,Heart failure,Multiple Sclerosis,HypertensionFatal Familial Insomnia Factor V Leiden Mutation ,Epilepsy Dupuytren's disease,Desmoplastic small-round-cell tumor Diabetes ,Coeliac disease,Creutzfeldt–Jakob disease,Cerebral Amyloid Angiopathy, Ataxia,Arthritis,Amyotrophic Lateral Scoliosis,Fibromyalgia,Fluoroquinolone Toxicity
    Syndrome Fibrodysplasia Ossificans ProgresSclerosis,Seizures,Adrenocortical carcinoma.Asthma,Allergic diseases,,Copd,Glaucoma., Cataracts,Macular degeneration,Cardiovascular disease,Lung disease.Enlarged prostate,Osteoporosis.
    Dementia.,Lyme Disease,,Non Hodgkin Lymphoma,Skin Cancer,Uterine Cancer,Prostate Cancer Dercum,Hpv,Weak Erection,Infertility,fibromyalgia,Get Your Ex Back,Als,SYPHILLIS,Colo-Rectal Cancer,Blood Cancer,Breast CANCER,Lung Cancer,Prostate Cancer,Brain Cancer,Genetic disease,Epilepsy, Parkinson's disease..You can free yourself of this Herpes virus by consulting this great African Herbal Doctor via this e-mail: / or call and whatsapp him on +2348149277967 He will help you and his herb medication is sure. he has the cure on all disease .You can talk to me on INSTAGRAM..tashamoore219....

  2. I was diagnosed of Herpes 2 years ago and I have tried all possible means to get the cure but all to no avail, until I saw a post in a health forum about a Herbal Doctor(Dr Akhigbe) who prepares herbal medicine to cure all kind of diseases including Herpes, at first i doubted, if it was real but decided to give him a trial, when I contacted Dr Akhigbe through his Email: he guided me and prepared a herbal medicine and sent it to me via courier Delivery service,when I received the package (herbal medicine) He gave me instructions on how to consume it,I started using it as instructed and I stopped getting outbreaks and the sores started vanishing, could you believe I was cured of this deadly virus within two to three weeks and notices changes in my body. Days of using this REMEDY,couldn't believe the healing at first until I see it as my HERPES  get cleared like magic Dr Akhigbe also use his herbal medicine to cure diseases like, HIV, HERPES, CANCER, ALS, CHRONIC DISEASE, HEART DISEASE, LUPUS, ASTHMA,  DIABETES, MARBURG VIRUS,  HEPATITIS A AND B.ECZEMA, BACK PAIN, EXTERNAL INFECTION ,ASTHMA, MALARIA, DENGUE FEVER, BACTERIA DIARRHEA, RABIES, OBESITY, PROGERIA,  MENINGITIS, ARTHRITIS, EPILEPSY,STROKE, LYMPHEDEMA, GALLSTONE, PULMONARY HYPERTENSION, PENIS  EJACULATION, UTIVE, LCERA  HPV, OSTEOPOROSIS, RHEUMATISM, THYROID, COLD & FLU,KIDNEY DISEASE,ACME. TOXOPLASMOSISM  ERYSIPELAS. etc Contact this great herbal Doctor today the father of herbal root cure. via Email: or whatsapp him  +2349010754824   and get cured permanently He is