Page 3 - 04- Celiac Disease

First-degree relatives: 5–20% incidence (1)
Second-degree relatives

Pediatric Considerations
No other risk factors (e.g., grain processing, genetically modified organisms, hygiene and illness
during childhood, breastfeeding, time of introduction of solid foods, pollution, tobacco use, and
medication) explain why some susceptible individuals develop celiac, whereas others do not (4).

COMMONLY ASSOCIATED CONDITIONS
Dermatitis herpetiformis (DH): 85% of patients with DH have celiac disease. All patients
should follow GFD (1).
Secondary lactase deficiency
Osteopenia and osteoporosis
Thyroid disease: Hashimoto thyroiditis
Type 1 diabetes: 3–10% of patients with type 1 diabetes also have celiac disease (1).
Symptomatic iron deficiency: 10–15% have celiac disease.
Elevated aspartate aminotransferase and alanine aminotransferase (with no direct cause)
Hyposplenism
Irritable bowel syndrome (IBS)
Restless leg syndrome
Celiac disease is associated with increased risk for adenocarcinoma and lymphoma of the
small bowel.
– The risk of lymphoproliferative malignancies depends on small intestinal histopathology.
– Little to no increased risk in latent celiac disease (seropositive but normal biopsy)
Associated autoimmune conditions (type 1 diabetes, autoimmune thyroiditis, primary biliary
cirrhosis, autoimmune hepatitis, psoriasis, Sjögren disease)
Associated genetic conditions (Down syndrome, IgA deficiency, Turner syndrome, Williams
syndrome)
Pregnancy Considerations
Prevalence of celiac disease: 2.5 to 3.5 times higher in women with unexplained infertility
Up to 19% of men with celiac disease have androgen resistance. Semen quality and likelihood
of pregnancy increase with GFD.
Higher rates of low birth weight, prematurity, spontaneous abortions, intrauterine growth
restriction, and stillbirths

Pediatric Considerations
Children with celiac disease at higher risk for type 1 diabetes, Down syndrome, Turner
syndrome, Williams syndrome, IgA deficiency, and autoimmune thyroid disease (5)[C]

DIAGNOSIS

HISTORY
Diarrhea, cramping are the most common GI symptoms.
Steatorrhea (fatty stools)
Abdominal pain or distension
Nausea, vomiting, flatulence