coeliac disease

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coeliac disease

A malabsorptive syndrome caused by hypersensitivity of intestinal mucosa to alpha-gliadin, a gluten extract composed of glutamine and proline-rich proteins that is found in wheat, barley, rye, and oats.
 
Clinical findings
Diarrhoea, copious fatty stools, abdominal distension, weight loss, haemorrhage, osteopenia, muscle atrophy, peripheral neuropathy, CNS and spinal cord demyelination (sensory loss, ataxia), amenorrhoea, infertility, oedema, petechiae, dermatitis herpetiformis (especially if HLA B27), alopecia areata. Occult bleeding occurs in half of patients.
 
Lab
Transaminases (ALT, AST) are increased in ± 40% of patients with CD, which usually normalises with a gluten-free diet; iron deficiency, anaemia due to occult bleeding.

Diagnosis
Duodenal biopsy; anti-gliadin and anti-endomysial antibodies.
 
Management
Eliminate gliadin from diet.

Prognosis
Without treatment, 10–15% develop lymphoma (e.g., immunoblastic lymphoma; less commonly, T cell lymphoma), a risk that increases with disease duration. CD predisposes to gastrointestinal lymphoma and carcinoma of the oral cavity and oesophagus; the otherwise rare small intestinal adenocarcinoma is 80-fold more common in CD.

ce·li·ac dis·ease

(sē'lē-ak di-zēz')
A disease occurring in children and adults characterized by sensitivity to gluten, with chronic inflammation and atrophy of the mucosa of the upper small intestine; manifestations include diarrhea, malabsorption, steatorrhea, and nutritional and vitamin deficiencies.
Synonym(s): gluten enteropathy, coeliac disease.

coeliac disease

An intestinal disorder caused by intolerance to the gluten proteins the gliadins, hordeins and secalins in wheat, barley and rye. The intestinal mucosa becomes infiltrated with CD8 and CD4 lymphocytes (T cells) leading to crypt hyperplasia and atrophy of the absorbing VILLI. The result is MALABSORPTION, especially of fats, with fat excretion in the stools (STEATORRHOEA). The condition is also called ‘gluten-induced enteropathy’.
coeliac disease; gluten-sensitive enteropathy autoimmune-mediated, familial, genetic and environmental tendency to small-intestine inflammation due to gluten allergy, characterized by gluten (wheat) intolerance and resultant malabsorption of food; characterized by abdominal pain, chronic diarrhoea, weight loss and mouth ulcers; presents at any age, predominantly affecting females, atopic individuals, those with autoimmune disease (e.g. thyroid disease, type 1 diabetes mellitus, inflammatory bowel disease), chronic liver disease and fibrosing alveolitis; it characteristically causes dermatitis herpetiformis

ce·li·ac dis·ease

(sē'lē-ak di-zēz') [MIM*212750]
A disease occurring in children and adults characterized by sensitivity to gluten, with chronic inflammation and atrophy of the mucosa of the upper small intestine.
Synonym(s): gluten enteropathy, coeliac disease.