March 2014

Celiac DiseaseA Review

Author Affiliations
  • 1Section of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of Chicago, Chicago, Illinois
  • 2Section of Pediatric Gastroenterology, Department of Pediatrics, and Prince Abdullah Bin Khalid Celiac Disease Center, King Saud University Faculty of Medicine, and King Khalid University Hospital, Riyadh, Saudi Arabia
  • 3University of Chicago Celiac Disease Center, Chicago, Illinois

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JAMA Pediatr. 2014;168(3):272-278. doi:10.1001/jamapediatrics.2013.3858

Triggered by the ingestion of gluten in genetically predisposed individuals, celiac disease is the most common genetically based food intolerance in the world, with a prevalence among approximately 1% of the general population. This enteropathy may appear at any age and is characterized by a wide variety of clinical signs and symptoms that go well beyond the gastrointestinal tract. In young children, gastrointestinal presentations are common and include chronic diarrhea, failure to thrive, and abdominal distention; however, extraintestinal manifestations are becoming increasingly more common. They include numerous conditions such as dermatitis herpetiformis, anemia, dental enamel hypoplasia, recurrent oral aphthae, short stature, osteoporosis, arthritis, neurologic problems, unexplained elevation of transaminase levels, and female infertility. Therefore, diagnosing celiac disease requires a high degree of suspicion, followed by correct screening and a confirmatory test with an intestinal biopsy. After diagnosis, a strict gluten-free diet must be followed, which in most cases will bring a marked improvement of symptoms. However, there are important compliance and quality-of-life problems, especially in adolescents.