Celiac disease Journal of Allergy and Clinical Immunology

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Presentation transcript:

Celiac disease Journal of Allergy and Clinical Immunology Peter H.R. Green, MD, Benjamin Lebwohl, MD, MS, Ruby Greywoode, MD Journal of Allergy and Clinical Immunology Volume 135, Issue 5, Pages 1099-1106 (May 2015) DOI: 10.1016/j.jaci.2015.01.044 Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 The pathogenesis of CD involves a triad of predisposing genes, gluten, and environmental factors. The main genes in CD are the HLA-DQ2 and/or HLA-DQ8 haplotypes. Dietary gluten is the major exposure among patients with CD. Numerous other environmental factors influence the development of CD but are less well defined than gluten. The reaction to gluten fragments occurs at the small intestinal epithelium, with both an innate and adaptive immune response. The results are characteristic autoantibodies, histologic changes (intraepithelial lymphocytosis and villous atrophy), and clinical symptoms (eg, diarrhea or iron deficiency anemia). Journal of Allergy and Clinical Immunology 2015 135, 1099-1106DOI: (10.1016/j.jaci.2015.01.044) Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Left, Normal duodenal histology. Right, Duodenal biopsy specimen showing partial villous atrophy with shortening of villi and lengthening of crypts, as well as a diffuse increase in intraepithelial lymphocyte numbers, which are consistent with a Marsh IIIa lesion. Journal of Allergy and Clinical Immunology 2015 135, 1099-1106DOI: (10.1016/j.jaci.2015.01.044) Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions