Celiac Disease

Celiac Disease • 1/150 people; all ages, all races • Inflammatory response to dietary gluten in genetically susceptible individuals • Classic symptoms: Diarrhea, CONSTIPATION (10%), anorexia, vomitting, abdominal distention, weight loss/FTT – Most likely to be present in younger patients – atypical symptoms common in older patients

• Best screen: Tissue Transglutaminase (TTG)-IgA (w/ IgA level) – 97% sensitive/specific – anti-Endomysial IgA expensive and operator dependant

• 20% of kids < 18mo have false negative TTG or EMA – Should add antigliadin antibodies (there is an ARUP panel for this)

• Must screen: 1st degree relatives (10%), T21, type I DM, Turner, Williams, selective IgA deficiency • Fe-def anemia unresponsive to therapy, vitamin def, transaminitis, short stature, delayed puberty, arthralgias