[Micronutrient deficiencies and celiac disease in Pediatrics]

Area of Science:

• Gastroenterology and Nutrition Science

Context:

• Celiac disease (CD) exhibits evolving clinical presentations, increasingly manifesting as silent disease in older individuals.
• The underlying enteropathy in CD significantly impairs the absorption of both macronutrients and micronutrients.

Purpose:

• To highlight the spectrum of micronutrient deficiencies associated with celiac disease.
• To emphasize the importance of monitoring micronutrient status in CD patients.

Summary:

• Celiac disease leads to malabsorption of essential micronutrients including iron, zinc, copper, folate, calcium, and vitamins E, D, B12, and B6.
• Ferropenic anemia is a common sign, while zinc deficiency impacts growth and immunity. Vitamin D absorption is affected by small bowel compromise.
• The pathophysiology of vitamin B12 deficiency remains unclear but should be considered in CD patients with neurological or hematological changes. Copper deficiency is noted primarily in adults.

Impact:

• Underscores the need for periodic assessment of micronutrient levels during celiac disease follow-up.
• Suggests investigating celiac disease in patients presenting with clinical signs of micronutrient deficiencies.