Coeliac disease

Coeliac disease is a chronic inflammatory autoimmune gastrointestinal disorder. Ingestion of gluten-containing foods leads to inflammatory reactions in the gastrointestinal immune, causing anything from typical, small intestinal, mucosal lesions to complete intestinal villous atrophy, in genetically predisposed individuals (HLA-DQ-2/8). Coeliac disease may present with classic abdominal symptoms, such as chronic diarrhoea, constipation and flatulence, but may also present with general symptoms, such as fatigue, decreased concentration or lethargy. Comorbidities, such as iron deficiency anaemia, osteoporosis and growth disorders in children, may occur as a consequence of deficient nutrition. Untreated cases of coeliac disease are at increased risk of malignant disorders.  Antibodies to tissue transglutaminase (tTG) are formed during the course of the autoimmune reaction, which is triggered by deamidated gliadin peptides (dGP) – a component of gluten – and these antibodies are a suitable biomarker for diagnosing coeliac disease. Measurement of the anti-tTG/anti-dGP antibody titre must not be conducted when potential patients are not ingesting gluten, since the specific antibodies may no longer be detectable.