Celiac disease (CD) is an autoimmune disorder occurring in genetically susceptible individuals, being characterized by inflammatory injury of the small intestine mucosa after ingestion of wheat gluten or related barley or rye products. The condition can develop at any age, although symptoms are most likely to appear during early childhood, between 9 and 18 months. Clinical presentation includes a family history and a range of symptoms such as recurrent abdominal pains, diarrhea, vomiting, bloating and flatulence, iron-deficiency anemia, weight loss, asthenia, and failure to thrive. The standard diagnostic criteria of CD require a clinical context, together with new serologic tests for antibodies against tissue transglutaminase and deamidated gliadin peptide, and especially characteristic histologic findings in small bowel biopsies (the gold standard for diagnosis). Gluten-free diet is the cornerstone therapy of CD. Although safe and effective, this method is not ideal: it is of limited nutritional value, expensive, and compliance or life quality problems are described in many countries. Consequently, alternative therapeutic strategies were developed to decrease the immunogenicity and to prevent the absorption of glutencontaining grains, together with strategies to limit T-cell migration or re-establish mucosal homeostasis. Celiac disease can appear in various associations, with atypical clinical presentation, requiring careful and early diagnosis for introducing the gluten-free diet as soon as possible, and for reducing the rate of subsequent complications.
Keywords:- celiac disease
- childhood
- gluten-free diet.