[Gluten intolerance in infants and children: diagnosis and what recommendations?]

Gluten intolerance in infants and children: what diagnosis and what recommendations? Gluten intolerance or celiac disease is a relatively common pathology that is still underdiagnosed in pediatrics due to its heterogeneous presentation. Apart from the classic form of malabsorption with diarrhea and growth retardation, pathology should be sought in the event of a family history of celiac disease, autoimmunity and in the context of certain syndromes. Other clinical or laboratory signs should also suggest the diagnosis. Any suspicion should lead to assays for total IgA and anti- transglutaminase IgA. If the child is symptomatic or not, the absence of upper gastrointestinal endoscopy with biopsies is possible to make the diagnosis after agreement of the family, if the levels of anti-transglutaminase IgA are greater than 10 times the upper limit of normal, and if the anti-endomysium IgA, assayed on a second sample, are also positive. Management is based on a strict gluten-free diet.