Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition.
Celiac disease is an immune-mediated enteropathy caused by a permanent sensitivity to gluten in genetically susceptible individuals. It occurs in children and adolescents with gastrointestinal symptoms, dermatitis herpetiformis, dental enamel defects, osteoporosis, short stature, delayed puberty and persistent iron deficiency anemia and in asymptomatic individuals with type 1 diabetes, Down syndrome, Turner syndrome, Williams syndrome, selective immunoglobulin (Ig)A deficiency and first degree relatives of individuals with celiac disease. The Celiac Disease Guideline Committee of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition has formulated a clinical practice guideline for the diagnosis and treatment of pediatric celiac disease based on an integration of a systematic review of the medical literature combined with expert opinion. The Committee examined the indications for testing, the value of serological tests, human leukocyte antigen (HLA) typing and histopathology and the treatment and monitoring of children with celiac disease. It is recommended that children and adolescents with symptoms of celiac disease or an increased risk for celiac disease have a blood test for antibody to tissue transglutaminase (TTG), that those with an elevated TTG be referred to a pediatric gastroenterologist for an intestinal biopsy and that those with the characteristics of celiac disease on intestinal histopathology be treated with a strict gluten-free diet. This document represents the official recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition on the diagnosis and treatment of celiac disease in children and adolescents.
Hill
Ivor D
ID
North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, Flourtown, PA 19031, USA.
Dirks
Martha H
MH
Liptak
Gregory S
GS
Colletti
Richard B
RB
Fasano
Alessio
A
Guandalini
Stefano
S
Hoffenberg
Edward J
EJ
Horvath
Karoly
K
Murray
Joseph A
JA
Pivor
Mitchell
M
Seidman
Ernest G
EG
D000293:Adolescent; D001323:Autoantibodies / Q000097:blood; D002446:Celiac Disease / Q000175:diagnosis* / Q000178:diet therapy / Q000473:pathology / Q000628:therapy*; D002648:Child; D005260:Female; D005983:Glutens / Q000008:administration & dosage; D006801:Humans; D008297:Male; D012698:Serologic Tests; D012955:Societies, Medical; D011503:Transglutaminases / Q000276:immunology
D001323:Autoantibodies; D005983:Glutens; D011503:Transglutaminases