4 groups of common deficiencies in Celiac disease Ms. Schilling - ANS 1.
Macronutrients: carbs, fats, proteins 2. Essential fatty acids and amino acids 3.
Minerals: iron, calcium, magnesium, copper, zinc 4. Vitamins: lipid soluble
(A,E,D,K), B vitamins, C vitamins
5 complications specific to Celiac disease for Ms. Schilling - ANS 1.
Malnutrition: if left untreated, happens in spite of adequate diet, deficiency in
vitamins/minerals, vitamin D, folate, iron, anemia, weight loss 2. Loss of calcium
and bone density: loss of fat in stool causing calcium and vitamin D loss, may
result in osteomalacia, osteoporosis 3. Lactose intolerance: damage to small
intestine from gluten can cause sensitivities to other foods like dairy, may or may
not resolve with gluten-free diet 4. Cancer: if gluten-free diet not maintained
greater chance of cancers including intestinal lymphoma and bowel cancers 5.
Neurological complications: Celiac disease associated with nervous system
disorders including seizures and peripheral neuropathy
Absorption and digestion factors in Celiac disease Ms. Schilling - ANS Specific
enzymes and transport proteins on the cell surface of mucosal cells to finish
digestion. Less energy coming in and being utilized than usual. Lipid absorption
will also be affected due to less cells and villi on the surface. Losing surface area,
enzymes, and transport proteins.
Antigen recognizing cells in Celiac disease Ms. Schilling case - ANS HLA-DQ2
HLA-DQ8
Celiac disease immune response Ms. Schilling case - ANS Not able to fully
break down gluten, likely due to high proline content. If perforation in gut barrier
then will cause reaction. Antigen recognizing cells HLA-DQ2 HLA-DQ8 recognize
gluten. Gluten doesn't quite fit in receptor so TTG needs to change conformation
in order to fit.
Clues about the patient's stool for Ms. Schilling - ANS If floating high fat
content, if watery the colon is not able to absorb water, urgency also indicates
more water in stool