THE BASIC OF CELIAC DISEASE

Armita Athennia
 CELIAC DISEASE
• Penyakit bawaan lahir
• Reaksi terhadap gluten
• Tubuh memberikan reaksi autoimun, dalam
bentuk :
• Belum ada obat yang dapat meredakan atau
menyembuhkan
• The only treatment option : gluten free life
style
REAKSI TERHADAP GLUTEN PADA
KASUS CELIAC DISEASE

Gluten yang terabsorbsi pada usus halus akan

berinteraksi dengan Antigen Presenting Cell
(APC) pada lamina propia, yang menyebabkan
reaksi inflamasi pada mukosa usus halus
Normal small intestine Normal villi

Celiac Disease Villous atrophy

 Risk Factors for Celiac Disease
Prevalence among
Risk factor those with risk factor (%)

Dermatitis herpetiformis 100

First-degree relative with 5 to 22
celiac disease
Autoimmune thyroid disease 1.5 to 14
Down syndrome 5 to 12
Turner's syndrome 2 to 10
Type 1 diabetes mellitus
Children 3 to 8
Adults 2 to 5
Dermatitis Herpetiformis
 Signs and Symptoms
• Common • Uncommon
– Diarrhea – Osteopenia/ osteoporosis
– Fatigue – Abnormal liver function
– Borborygmus – Vomiting
– Abdominal pain – Iron-deficiency anemia
– Weight loss – Neurologic dysfunction
– Abdominal distention – Constipation
– Flatulence – Nausea
– Children : Failure to
thrive
 Differential Diagnosis of Celiac Disease
• Anorexia nervosa
• Autoimmune enteropathy
• Bacterial overgrowth
• Collagenous sprue
• Crohn's disease
• Giardiasis
• Human immunodeficiency
virus enteropathy
• Hypogammaglobulinemia
• Infective gastroenteritis
• Intestinal lymphoma
• Irritable bowel syndrome
• Ischemic enteritis
• Lactose intolerance
• Pancreatic insufficiency
• Soy protein intolerance
• Tropical sprue
• Tuberculosis
• Whipple's disease
• Zollinger-Ellison syndrome
 American Gastroenterological Association Institute
Recommendations for Celiac Disease Screening
• Consider testing in symptomatic patients at high risk for
celiac disease with any of the following conditions:
– Autoimmune hepatitis
– Down syndrome
– Premature onset of osteoporosis
– Primary biliary cirrhosis
– Unexplained elevations in liver transaminase levels
– Unexplained iron deficiency anemia
 Test selectively as part of the medical evaluation
when symptoms could be secondary to celiac disease:

– Autoimmune thyroid – Selective immunoglobulin A

disease deficiency
– Cerebellar ataxia – Short stature (in children)
– First- or second-degree – Sjögren's syndrome
relative with celiac – Turner's syndrome
disease – Type 1 diabetes mellitus
– Irritable bowel syndrome – Unexplained delayed puberty
– Peripheral neuropathy – Unexplained recurrent fetal loss
– Recurrent migraine
 GLUTEN FREE LIFESTYLE
• All food, cosmetics, bath products,
medications must be gluten free
– No wheat based products
– Not processed around wheat or barley
• Contamination causes reaction
— Even small amounts of gluten in food will effect a celiace
— Contamination examples:
o Eating on a served plate wich previously held bread or bakery
product
o Inhaling and swallowing air borne wheat flour at bakery store
TERIMA KASIH