Celiac disease patients are quite common, but most go undiagnosed, in part because practitioners ignore the sheer diversity of associated symptoms and fail to include celiac disease in the differential diagnosis. For patients with established celiac disease, pediatricians should have some knowledge of the gluten-free diet and recommendations for annual follow-up care.
Celiac disease (CD) is an autoimmune enteropathy triggered by the ingestion of gluten in genetically predisposed individuals. Removing gluten, a compound protein found in wheat, barley and rye, from the diet reverses intestinal damage and relieves signs and symptoms. Previously, CD was thought to occur mainly in young children of European descent; however, with better serological testing, recognition of potential manifestations, and more widespread testing, we now know that CD affects all age groups and occurs worldwide, with an average prevalence of around 1 in people. 100. (1) (2) Variations exist with certain groups, such as the Sahrawi population of Western Sahara in Africa and Spain, with estimates of 1 in 18 having CD, (3) while in most parts of Asia except India the incidence of CD is quite low. …