Question 25 -
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Presentations of Coeliac Disease: steatorrhoe/offensive stools, bloating, nausea, vomiting, aphthous ulcers, angular stomatitis, weight loss, fatigue, weakness, iron-deficiency anaemia, osteomalacia, failure to thrive (children).1/3 may be asymptomatic.
Dermatitis herpetiformis is associated with celiac disease (itchy blisters in groups eg on knees, elbows and scalp)
Howell Jolly bodies are nuclear remnants seen in RBCs post splenectomy, rarely leukaemis, megaloblastic anaemia, iron-deficiency anaemia, hyposplenism (eg celiac disease, neonates, thalassaemia, SLE, lymphoma, leukaemia, amyloid)
The mucosal of the proximal small bowel is predominantly affected, the mucosal damage decreasing in severity towards the ileum as the gluten is digested into smaller non-toxic fragments.
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