Gluten-sensitive enteropathy is most strongly associated with
Celiac disease (gluten-sensitive enteropathy)*Genetic predisposition: HLA-DQ2 and HLA-DQ8*Pathogenesis: Gluten contains an alcohol-soluble fraction called "gliadin" which resist degradation by gastric, pancreatic and small intestinal proteases. Such gliadins induce CD8+ T cell response and damage epithelial cells. Through the damaged epithelium, other gliadin were transpoed which are deamidated by tissue transglutaminase. Deamidated gliadins interact with HLA-DQ2 or HLA-DQ8 of antigen presenting cells and induce a CD4 response. *Microscopic findings: Villous atrophy, crypt hyperplasia, and intraepithelial lymphocytosis. Based on these 3 findings, celiac disease was typed by Marsh classification.*Most sensitive test: Anti-TTG antibody test*Most specific test: Anti-endomysial antibody test*Most common skin manifestation in celiac disease patients: Dermatitis herpetiformis *Most common celiac disease associated cancer: Enteropathy-associated T cell lymphoma.Ref: Robbins 8/e p795
HLA DQ2
HLA DR4
HLA DQ3
Blood group B
G.I.T