Coeliac disease in children.

Abstract

Coeliac disease is an immune-mediated systemic disorder caused by ingestion of gluten. The condition presents classically with gastrointestinal signs including diarrhoea, bloating, weight loss and abdominal pain, but presentations can include extra-intestinal symptoms such as iron-deficiency anaemia, faltering growth, delayed puberty and mouth ulcers. Some children are at higher risk of developing coeliac disease, for example those with a strong family history, certain genetic disorders and other autoimmune conditions. If coeliac disease is suspected, serological screening with anti-tissue transglutaminase titres should be performed and the diagnosis may be confirmed by small bowel biopsy while the child remains on a normal (gluten-containing) diet. Modified European guidelines recommend that symptomatic children with anti-tissue transglutaminase titres more than ten times the upper limit of normal, and positive human leucocyte antigen (HLA)-DQ2 or HLA-DQ8 status, do not require small bowel biopsy for diagnosis of coeliac disease. Management of the disease involves strict adherence to a lifelong gluten-free diet, which should lead to resolution of symptoms and prevention of long-term complications. Healthcare professionals should be aware of the varied presentations of coeliac disease to ensure timely screening and early initiation of a gluten-free diet.

• Authors: Siba Prosad Paul, Emily Natasha Kirkham, Sarah Pidgeon, Sarah Sandmann
• Journal: Nursing standard (Royal College of Nursing (Great Britain) : 1987) (Nurs Stand) Vol. 29 Issue 49 Pg. 36-41 (Aug 05 2015) ISSN: 2047-9018 [Electronic] England
• PMID: 26243121 (Publication Type: Journal Article, Review)

Chemical References

• HLA-DQ Antigens
• HLA-DQ2 antigen
• HLA-DQ8 antigen

Topics

• Adolescent
• Celiac Disease (diagnosis, immunology, therapy)
• Child
• Child, Preschool
• Diet, Gluten-Free
• Female
• HLA-DQ Antigens (immunology)
• Humans
• Intestine, Small (immunology)
• Male