Celiac Disease: Working Group Report of the First World Congress of Pediatric Gastroenterology, Hepatology, and Nutrition

Celiac disease (CD) is an autoimmune condition characterized by an immune-mediated enteropathy of the small intestine. The condition occurs in genetically predisposed individuals who ingest prolamins (alcoholsoluble proteins rich in glutamine and proline) that are found in wheat, rye, and barley. CD produces a spectrum of small intestinal mucosal changes ranging from an increase in the number of intraepithelial lymphocytes to mucosal remodeling with crypt hyperplasia and flattening of the villi. Malabsorption of nutrients is a consequence of the intestinal damage and when prolonged can cause malnutrition. Treatment requires lifelong adherence to a diet that strictly eliminates products containing wheat, rye, and barley. On such a diet, complete recovery of the small intestinal damage can be expected with reversal of nutritional deficits and resolution of symptoms.