Description
Coeliac disease is a T cell-mediated autoimmune response
stimulated by rye, wheat, barley and occasionally oat
proteins. A genetic predisposition to coeliac disease has been
established. The culprit is the presence of the HLA-DQ2
molecule with prevalence rising to 1%. It is believed that the
T-cell mediated response is triggered by a 33-mer peptide
in A2 gliadin resulting in damage to the jejunal mucosa.
Malabsorbtion of nutrients and thus a failure to thrive are
more common in infancy. Tiredness, anaemia, bowel or
bone disorders can develop at all ages, while silent coeliac
disease is escalating. The main treatment is a gluten free
diet which must be strictly adhered to, in order for it to be
effective.. Nevertheless, determining the amount of gluten to
be allowed in gluten free foods remains an unresolved issue.
