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Celiac disease in children.

Hélène Garnier-Lengliné1, Nadine Cerf-Bensussan2, Frank M Ruemmele1

  • 1Université Paris-Descartes, Sorbonne Paris-Cité, Paris, France; AP-HP, hôpital Necker-Enfants-Malades, service de gastroentérologie, hépatologie et nutrition pédiatriques, 149, rue de Sèvres, 75743 Paris cedex 15, France; Unité Inserm UMR_S1163, Institut Imagine, Paris, France.

Clinics and Research in Hepatology and Gastroenterology
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Summary

Celiac disease is an autoimmune disorder triggered by gluten in susceptible individuals. A strict gluten-free diet is the only effective treatment, managing symptoms and preventing long-term complications.

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Area of Science:

  • Gastroenterology
  • Immunology
  • Genetics

Background:

  • Celiac disease is an autoimmune enteropathy triggered by gluten in genetically predisposed individuals.
  • It presents in symptomatic and pauci-symptomatic forms, with an estimated prevalence of 1/100 to 1/400.
  • Classical celiac disease involves diarrhea, failure to thrive, and bloating in infants after gluten introduction.

Purpose of the Study:

  • To summarize the clinical presentation, diagnosis, and management of celiac disease.
  • To highlight the role of serological tests and HLA genotyping in diagnosis.
  • To discuss the implications of recent European guidelines on diagnostic procedures.

Main Methods:

  • Review of clinical presentations and diagnostic criteria for celiac disease.
  • Analysis of serological markers (anti-transglutaminase, anti-endomysium antibodies) and HLA genotyping.
  • Evaluation of the efficacy and long-term benefits of a gluten-free diet.

Main Results:

  • Serological tests and duodenal biopsies are key diagnostic tools, though guidelines are evolving.
  • Absence of HLA-DQ2 or DQ8 alleles has high negative predictive value.
  • Gluten-free diet leads to clinical remission and prevents complications like osteoporosis and cancers.

Conclusions:

  • The gluten-free diet is the sole effective treatment for celiac disease, inducing remission and preventing long-term health issues.
  • Diagnostic approaches are being refined, with a potential shift away from routine endoscopy in specific cases.
  • Early diagnosis and consistent adherence to a gluten-free diet are crucial for managing celiac disease and its associated risks.