Patients with celiac disease are fairly common, but most remain undiagnosed, in part because clinicians recognize the extreme diversity of associated symptoms and do not 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 caused by the ingestion of gluten in genetically susceptible individuals. Withdrawal of 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 possible manifestations and more widespread testing, we now know that CD affects all age groups and occurs worldwide, with an average prevalence of about 1 in 100 individuals. (1) (2) There are variations among some groups, such as the Sahrawi populations of Western Sahara, Africa and Spain, with estimates of 1 in 18 with CD, (3) while in most parts of Asia, with the exception of India , the incidence of CD is quite low. …
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