Hello and welcome to the Zero to Finals podcast.

My name is Tom and in this episode I'm going to be talking to you about

celiac disease in children.

And if you want to follow along with written notes on this topic,

you can follow along at zero definals.com slash celiac disease

or in the gastroenterology section of the zero definals pediatrics book.

So let's get straight into it.

Celiac disease is an autoimmune condition where exposure to gluten in food products causes an

immune reaction that creates inflammation in the small intestine.

It usually develops in early childhood, but it can start at any age.

In celiac disease, auto-antibodies are created in response to exposure to gluten.

These auto-antibodies target the epithelial cells of the intestine and lead to inflammation.

There are two antibodies to remember, anti-tissue transglutaminase or anti-TTG, and anti-endemisial

or anti-EMA antibodies. These antibodies correlate with disease activity and will rise with more disease and

then disappear with effective treatment. Inflammation affects the small bowel, particularly

the jejunum. It causes atrophy of the intestinal villi. The intestinal cells have villi

on them that help with absorbing nutrients from the food

passing through the intestine. The inflammation causes malabsorption of nutrients and disease-related

symptoms. So how does it present? Well, celiac disease is often asymptomatic, so have a low

threshold for testing for celiac disease in patients where it's

suspected. Symptoms can include failure to thrive in young children, diarrhea, fatigue, weight loss,

mouth ulcers, anemia due to iron, B12 or folate deficiency, and a rash called dermatitis hepatiformis,

...