Pediatric Celiac Disease - A Review.

Our understanding of celiac disease is rapidly expanding. Previously thought to be a rare food intolerance, celiac disease is now recognized as a multifactorial autoimmune disorder with a vast array of presentations. Symptoms range from classic diarrhea, weight loss, and abdominal pain to constipation and extra-intestinal manifestations including anemia, elevated transaminase levels, osteoporosis, or aphthous stomatitis. Some cases are "silent" with no apparent symptoms at all. Although endoscopic biopsy and histology findings remain the gold standard for confirmatory diagnosis, serologic testing options continue to advance. Tissue-transglutaminase (tTG) IgA antibody levels alone have shown high sensitivity and specificity in patients over 2 years of age. The mainstay of treatment remains strict lifetime adherence to a gluten-free diet. Further discussion on the prevalence, pathogenesis, presentation, testing, and management of celiac disease will follow. Copyright© South Dakota State Medical Association.