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Pediatric Celiac Disease Differential Diagnoses

  • Author: Stefano Guandalini, MD; Chief Editor: Carmen Cuffari, MD  more...
 
Updated: Jun 28, 2016
 
 
 
Contributor Information and Disclosures
Author

Stefano Guandalini, MD Founder and Medical Director, Celiac Disease Center, Chief, Section of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Chicago Medical Center; Professor, Department of Pediatrics, Section of Gastroenterology, Hepatology and Nutrition, University of Chicago Division of the Biological Sciences, The Pritzker School of Medicine

Stefano Guandalini, MD is a member of the following medical societies: American Gastroenterological Association, North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, European Society for Paediatric Gastroenterology, Hepatology & Nutrition, North American Society for the Study of Celiac Disease

Disclosure: Received consulting fee from AbbVie for consulting.

Coauthor(s)

Phyllis A Vallee, MD Associate Program Director, Department of Emergency Medicine, Henry Ford Hospital

Phyllis A Vallee, MD is a member of the following medical societies: American Academy of Emergency Medicine, American Medical Association, Michigan State Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Carmen Cuffari, MD Associate Professor, Department of Pediatrics, Division of Gastroenterology/Nutrition, Johns Hopkins University School of Medicine

Carmen Cuffari, MD is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association, North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, Royal College of Physicians and Surgeons of Canada

Disclosure: Received honoraria from Prometheus Laboratories for speaking and teaching; Received honoraria from Abbott Nutritionals for speaking and teaching.

Chief Editor

Carmen Cuffari, MD Associate Professor, Department of Pediatrics, Division of Gastroenterology/Nutrition, Johns Hopkins University School of Medicine

Carmen Cuffari, MD is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association, North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, Royal College of Physicians and Surgeons of Canada

Disclosure: Received honoraria from Prometheus Laboratories for speaking and teaching; Received honoraria from Abbott Nutritionals for speaking and teaching.

Additional Contributors

Jorge H Vargas, MD Professor of Pediatrics and Clinical Professor of Pediatric Gastroenterology, University of California, Los Angeles, David Geffen School of Medicine; Consulting Physician, Department of Pediatrics, University of California at Los Angeles Health System

Jorge H Vargas, MD is a member of the following medical societies: American Liver Foundation, Latin American Society of Pediatric Gastroenterology, Hepatology & Nutrition, American Society for Gastrointestinal Endoscopy, American Society for Parenteral and Enteral Nutrition, North American Society for Pediatric Gastroenterology, Hepatology and Nutrition

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author Ginette V Busschots, MD, to the writing and development of this article.

References
  1. Guandalini S, Setty M. Celiac disease. Curr Opin Gastroenterol. 2008 Nov. 24(6):707-12. [Medline].

  2. Husby S, Koletzko S, Korponay-Szabó IR, Mearin ML, Phillips A, Shamir R, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease. J Pediatr Gastroenterol Nutr. 2012 Jan. 54(1):136-60. [Medline].

  3. Rubio-Tapia A, Kyle RA, Kaplan EL, et al. Increased prevalence and mortality in undiagnosed celiac disease. Gastroenterology. 2009 Jul. 137(1):88-93. [Medline]. [Full Text].

  4. Tang F, Chen Z, Ciszewski C, et al. Cytosolic PLA2 is required for CTL-mediated immunopathology of celiac disease via NKG2D and IL-15. J Exp Med. 2009 Feb 23. [Medline].

  5. Barone MV, Troncone R, Auricchio S. Gliadin Peptides as Triggers of the Proliferative and Stress/Innate Immune Response of the Celiac Small Intestinal Mucosa. Int J Mol Sci. 2014 Nov 7. 15(11):20518-20537. [Medline].

  6. Marsh MN, Hinde J. Inflammatory component of celiac sprue mucosa. I. Mast cells, basophils, and eosinophils. Gastroenterology. 1985 Jul. 89(1):92-101. [Medline].

  7. Catassi C, Kryszak D, Louis-Jacques O, et al. Detection of Celiac disease in primary care: a multicenter case-finding study in North America. Am J Gastroenterol. 2007 Jul. 102(7):1454-60. [Medline].

  8. Riddle MS, Murray JA, Porter CK. The incidence and risk of celiac disease in a healthy US adult population. Am J Gastroenterol. 2012 Aug. 107(8):1248-55. [Medline].

  9. Catassi C, Kryszak D, Bhatti B, Sturgeon C, Helzlsouer K, Clipp SL. Natural history of celiac disease autoimmunity in a USA cohort followed since 1974. Ann Med. 2010 Oct. 42(7):530-8. [Medline].

  10. Catassi C, Cobellis G. Coeliac disease epidemiology is alive and kicking, especially in the developing world. Dig Liver Dis. 2007 Oct. 39(10):908-10. [Medline].

  11. Dydensborg S, Toftedal P, Biaggi M, Lillevang ST, Hansen DG, Husby S. Increasing prevalence of coeliac disease in Denmark: a linkage study combining national registries. Acta Paediatr. 2012 Feb. 101(2):179-84. [Medline].

  12. Lohi S, Mustalahti K, Kaukinen K, Laurila K, Collin P, Rissanen H, et al. Increasing prevalence of coeliac disease over time. Aliment Pharmacol Ther. 2007 Nov 1. 26(9):1217-25. [Medline].

  13. Walker MM, Murray JA, Ronkainen J, Aro P, Storskrubb T, D'Amato M. Detection of celiac disease and lymphocytic enteropathy by parallel serology and histopathology in a population-based study. Gastroenterology. 2010 Jul. 139(1):112-9. [Medline].

  14. Bach JF. The effect of infections on susceptibility to autoimmune and allergic diseases. N Engl J Med. 2002 Sep 19. 347(12):911-20. [Medline].

  15. Mårild K, Stephansson O, Montgomery S, Murray JA, Ludvigsson JF. Pregnancy outcome and risk of celiac disease in offspring: a nationwide case-control study. Gastroenterology. 2012 Jan. 142(1):39-45.e3. [Medline].

  16. Myléus A, Ivarsson A, Webb C, Danielsson L, Hernell O, Högberg L. Celiac disease revealed in 3% of Swedish 12-year-olds born during an epidemic. J Pediatr Gastroenterol Nutr. 2009 Aug. 49(2):170-6. [Medline].

  17. Myléus A, Hernell O, Gothefors L, Hammarström ML, Persson LÅ, Stenlund H, et al. Early infections are associated with increased risk for celiac disease: an incident case-referent study. BMC Pediatr. 2012 Dec 19. 12:194. [Medline]. [Full Text].

  18. Myléus A, Stenlund H, Hernell O, Gothefors L, Hammarström ML, Persson LÅ, et al. Early vaccinations are not risk factors for celiac disease. Pediatrics. 2012 Jul. 130(1):e63-70. [Medline].

  19. Zingone F, West J, Crooks CJ, Fleming KM, Card TR, Ciacci C, et al. Socioeconomic variation in the incidence of childhood coeliac disease in the UK. Arch Dis Child. 2015 May. 100 (5):466-73. [Medline].

  20. Lewis R. Pediatric Celiac Disease Diagnoses Tripled in 20 Years. Medscape Medical News. Available at http://www.medscape.com/viewarticle/838622. January 23, 2015; Accessed: September 30, 2015.

  21. Silano M, Volta U, Vincenzi AD, Dessì M, Vincenzi MD. Effect of a gluten-free diet on the risk of enteropathy-associated T-cell lymphoma in celiac disease. Dig Dis Sci. 2008 Apr. 53(4):972-6. [Medline].

  22. Sharaiha RZ, Lebwohl B, Reimers L, Bhagat G, Green PH, Neugut AI. Increasing incidence of enteropathy-associated T-cell lymphoma in the United States, 1973-2008. Cancer. 2012 Aug 1. 118(15):3786-92. [Medline].

  23. Metzger MH, Heier M, Maki M, et al. Mortality excess in individuals with elevated IgA anti-transglutaminase antibodies: the KORA/MONICA Augsburg cohort study 1989-1998. Eur J Epidemiol. 2006. 21(5):359-65. [Medline].

  24. Ludvigsson JF, Agreus L, Ciacci C, Crowe SE, Geller MG, Green PH, et al. Transition from childhood to adulthood in coeliac disease: the Prague consensus report. Gut. 2016 Apr 18. [Medline].

  25. Guandalini S, ed. Celiac Disease. In. Textbook of Pediatric Gastroenterology and Nutrition. London: Taylor & Francis;. 2004: 435-50.

  26. Campisi G, Di Liberto C, Carroccio A, Compilato D, Iacono G, Procaccini M, et al. Coeliac disease: oral ulcer prevalence, assessment of risk and association with gluten-free diet in children. Dig Liver Dis. 2008 Feb. 40(2):104-7. [Medline].

  27. Baydoun A, Maakaron JE, Halawi H, Abou Rahal J, Taher AT. Hematological manifestations of celiac disease. Scand J Gastroenterol. 2012 Dec. 47(12):1401-11. [Medline].

  28. Vajro P, Paolella G, Maggiore G, Giordano G. Meta-Analysis: Pediatric Celiac Disease, Cryptogenic Hypertransaminasemia, and Autoimmune Hepatitis. J Pediatr Gastroenterol Nutr. 2013 Feb 22. [Medline].

  29. Lionetti E, Francavilla R, Pavone P, et al. The neurology of coeliac disease in childhood: what is the evidence? A systematic review and meta-analysis. Dev Med Child Neurol. 2010 Mar 19. [Medline].

  30. Pope R, Sheiner E. Celiac disease during pregnancy: to screen or not to screen?. Arch Gynecol Obstet. 2009 Jan. 279(1):1-3. [Medline].

  31. Mårild K, Størdal K, Hagman A, Ludvigsson JF. Turner Syndrome and Celiac Disease: A Case-Control Study. Pediatrics. 2016 Feb. 137 (2):e20152232. [Medline].

  32. Osterweil N. Celiac Disease More Common in Patients With Turner Syndrome. Medscape Medical News. Available at http://www.medscape.com/viewarticle/857225. January 14, 2016; Accessed: June 27, 2016.

  33. Mårild K, Stephansson O, Montgomery S, Murray JA, Ludvigsson JF. Pregnancy outcome and risk of celiac disease in offspring: a nationwide case-control study. Gastroenterology. 2012 Jan. 142(1):39-45.e3. [Medline]. [Full Text].

  34. Akobeng AK, Ramanan AV, Buchan I, Heller RF. Effect of breast feeding on risk of coeliac disease: a systematic review and meta-analysis of observational studies. Arch Dis Child. 2006 Jan. 91(1):39-43. [Medline].

  35. Szajewska H, Chmielewska A, Piescik-Lech M, Ivarsson A, Kolacek S, Koletzko S, et al. Systematic review: early infant feeding and the prevention of coeliac disease. Aliment Pharmacol Ther. 2012 Oct. 36(7):607-18. [Medline].

  36. Olsson C, Hernell O, Hornell A, Lonnberg G, Ivarsson A. Difference in celiac disease risk between Swedish birth cohorts suggests an opportunity for primary prevention. Pediatrics. 2008 Sep. 122(3):528-34. [Medline].

  37. Troncone R, Auricchio S. Rotavirus and celiac disease: clues to the pathogenesis and perspectives on prevention. J Pediatr Gastroenterol Nutr. 2007 May. 44(5):527-8. [Medline].

  38. Bonamico M, Mariani P, Thanasi E, et al. Patchy villous atrophy of the duodenum in childhood celiac disease. J Pediatr Gastroenterol Nutr. 2004 Feb. 38(2):204-7. [Medline].

  39. Sharma A, Mews C, Jevon G, Ravikumara M. Duodenal bulb biopsy in children for the diagnosis of coeliac disease: Experience from Perth, Australia. J Paediatr Child Health. 2013 Feb 22. [Medline].

  40. [Guideline] Hill ID, Dirks MH, Liptak GS, et al. Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr. 2005 Jan. 40(1):1-19. [Medline].

  41. Rostom A, Murray JA, Kagnoff MF. American Gastroenterological Association (AGA) Institute technical review on the diagnosis and management of celiac disease. Gastroenterology. 2006 Dec. 131(6):1981-2002. [Medline].

  42. Barbato M, Maiella G, Di Camillo C, Guida S, Valitutti F, Lastrucci G, et al. The anti-deamidated gliadin peptide antibodies unmask celiac disease in small children with chronic diarrhoea. Dig Liver Dis. 2011 Jun. 43(6):465-9. [Medline].

  43. Giersiepen K, Lelgemann M, Stuhldreher N, Ronfani L, Husby S, Koletzko S, et al. Accuracy of diagnostic antibody tests for coeliac disease in children: summary of an evidence report. J Pediatr Gastroenterol Nutr. 2012 Feb. 54(2):229-41. [Medline].

  44. Kurppa K, Collin P, Viljamaa M, et al. Diagnosing mild enteropathy celiac disease: a randomized, controlled clinical study. Gastroenterology. 2009 Mar. 136(3):816-23. [Medline].

  45. Akobeng AK, Thomas AG. Systematic review: tolerable amount of gluten for people with coeliac disease. Aliment Pharmacol Ther. 2008 Jun 1. 27(11):1044-52. [Medline].

  46. Rubio-Tapia A, Rahim MW, See JA, Lahr BD, Wu TT, Murray JA. Mucosal recovery and mortality in adults with celiac disease after treatment with a gluten-free diet. Am J Gastroenterol. 2010 Jun. 105(6):1412-20. [Medline].

  47. Diamanti A, Ferretti F, Guglielmi R, et al. Thyroid autoimmunity in children with coeliac disease: a prospective survey. Arch Dis Child. 2011 Nov. 96(11):1038-41. [Medline].

  48. Leffler DA, Dennis M, Edwards GJ, et al. A Simple Validated Gluten-Free Diet Adherence Survey for Adults With Celiac Disease. Clin Gastroenterol Hepatol. 2009 Jan 11. [Medline].

  49. Husby S, Koletzko S, Korponay-Szabó IR, Mearin ML, Phillips A, Shamir R, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease. J Pediatr Gastroenterol Nutr. 2012 Jan. 54(1):136-60. [Medline].

  50. Isselbacher KJ, Braunwald E, Wilson JD. Harrison's Principles of Internal Medicine. 13th ed. New York, NY: McGraw Hill; 1994. 1398-400.

  51. Kelly CP, Green PH, Murray JA, Dimarino A, Colatrella A, Leffler DA, et al. Larazotide acetate in patients with coeliac disease undergoing a gluten challenge: a randomised placebo-controlled study. Aliment Pharmacol Ther. 2013 Jan. 37(2):252-62. [Medline].

  52. Kondrashova A, Mustalahti K, Kaukinen K, Viskari H, Volodicheva V, Haapala AM, et al. Lower economic status and inferior hygienic environment may protect against celiac disease. Ann Med. 2008. 40(3):223-31. [Medline].

  53. Lebwohl B, Rubio-Tapia A, Assiri A, Newland C, Guandalini S. Diagnosis of celiac disease. Gastrointest Endosc Clin N Am. 2012 Oct. 22(4):661-77. [Medline].

  54. McCance KL, Huether SE. Pathophysiology: The Biologic Basis for Disease in Adults and Children. St Louis, MO: Mosby; 1990. 1277-80.

  55. Panetta F, Torre G, Colistro F, Ferretti F, Daniele A, Diamanti A. Clinical accuracy of anti-tissue transglutaminase as screening test for celiac disease under 2 years. Acta Paediatr. 2011 May. 100(5):728-31. [Medline].

  56. Saltzman JR, Russell RM. The aging gut. Nutritional issues. Gastroenterol Clin North Am. 1998 Jun. 27(2):309-24. [Medline].

  57. University of Chicago Celiac Disease Center. FAQs. Available at http://www.cureceliacdisease.org/faqs. Accessed: March 11, 2013.

  58. USP. United States Pharmacopeial Convention: Drug Information (USP DI) for the Health Care Professional. 16th ed. Rockville, MD: United States Pharmacopeial Convention; 1996. 978-95.

  59. Walker-Smith JA, Guandalini S, Schmitz J, Shmerling DH, Visakorpi JK. Revised criteria for diagnosis of coeliac disease. Report of Working Group of European Society of Paediatric Gastroenterology and Nutrition. Arch Dis Child. 1990. 65:909-911. [Medline].

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