Hi, this is Tom, and in this episode I'm going to be going through celiac disease in children,

and you can find notes at zero to finals.com and in the zero to finals pediatrics book,

and you can find flashcards and questions at members.0tofinals.com. And at the end of the episode, we'll go

through some questions so you can test yourself on what you just heard. So let's jump straight in.

Celiac disease is an autoimmune condition triggered by eating gluten. It can develop at any age and it's thought to be caused by

genetic and environmental factors. There's a link with other autoimmune conditions,

particularly type 1 diabetes and autoimmune thyroid disease. A positive family history of

celiac disease increases the risk of developing the condition.

It's associated with certain human leukocyte antigen or HLA genotypes, specifically HLA DQ2 and HLADQ8.

Atomtip, children with type 1 diabetes and autoimmune thyroid disease are screened for

celiac disease even if they don't have symptoms.

Let's go through the pathophysiology. In patients with celiac disease, auto-antibodies,

meaning antibodies against the body's own tissues, are created in response to gluten. These auto-antibodies

target the epithelial cells of the small intestine, leading to inflammation.

The antibodies relate to disease activity and will rise with more active disease and may disappear

with effective management. There are three antibodies related to celiacs, and it's particularly worth remembering the

first two.

These antibodies are anti-tissue transglutamines antibodies, or anti-TTG, anti-endomyseal antibodies,

or anti-emisial antibodies, or anti-emaeamate, and anti-deamidated gliaidin peptide antibodies, or anti-DGP.

Inflammation affects the small bowel, particularly the jejunum.

The surface of the small intestine is covered in projections

called villi, which increase the surface area and help with nutrient absorption. Celiac disease

...