Patients with celiac disease are quite common, yet most remain undiagnosed, in part because practitioners underrecognize the extreme diversity of associated symptoms and fail to include celiac disease in the differential diagnosis. For patients with established celiac disease, pediatricians must have some knowledge regarding the gluten-free diet and recommendations for yearly follow-up care.

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Celiac disease (CD) is an autoimmune enteropathy triggered by ingestion of gluten in genetically susceptible individuals. Withdrawal of gluten, a compound protein found in wheat, barley, and rye, from the diet reverses the intestinal damage and relieves signs and symptoms. Previously, CD was thought to occur primarily in young children of European ancestry; however, with better serologic testing, recognition of potential manifestations, and more widespread testing, we now know that CD affects all age groups and occurs throughout the world, with an average prevalence of approximately 1 in...

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