A Sociedade Norte-americana de Gastroenterologia Pediátrica, Hepatologia e Nutrição formulou esta diretriz para servir de guia prático ao diagnóstico e tratamento da doença celíaca. A doença é detectada na infância ou adolescência pela presença frequente de alguns sintomas, como diarréia, dor abdominal, vômitos, constipação e distensão abdominal. Entretanto, algumas crianças e adolescentes assintomáticos também podem apresentar a doença. Dê uma olhada no guideline!!!!

Clinical Guideline
Guideline for the Diagnosis and Treatment of Celiac Disease
in Children: Recommendations of the North American Society
for Pediatric Gastroenterology, Hepatology and Nutrition

ABSTRACT
Celiac disease is an immune-mediated enteropathy caused by
a permanent sensitivity to gluten in genetically susceptible individuals.
It occurs in children and adolescents with gastrointestinal
symptoms, dermatitis herpetiformis, dental enamel
defects, osteoporosis, short stature, delayed puberty and persistent
iron deficiency anemia and in asymptomatic individuals
with type 1 diabetes, Down syndrome, Turner syndrome,Williams
syndrome, selective immunoglobulin (Ig)A deficiency and first
degree relatives of individuals with celiac disease. The Celiac
Disease Guideline Committee of the North American Society
for Pediatric Gastroenterology, Hepatology and Nutrition has
formulated a clinical practice guideline for the diagnosis and
treatment of pediatric celiac disease based on an integration of
a systematic review of the medical literature combined with
expert opinion.
The Committee examined the indications for testing, the value
of serological tests, human leukocyte antigen (HLA) typing and
histopathology and the treatment and monitoring of children
with celiac disease. It is recommended that children and adolescents
with symptoms of celiac disease or an increased risk
for celiac disease have a blood test for antibody to tissue
transglutaminase (TTG), that those with an elevated TTG be
referred to a pediatric gastroenterologist for an intestinal biopsy
and that those with the characteristics of celiac disease on
intestinal histopathology be treated with a strict gluten-free
diet. This document represents the official recommendations of
the North American Society for Pediatric Gastroenterology,
Hepatology and Nutrition on the diagnosis and treatment of
celiac disease in children and adolescents. JPGN 40:1–19,
2005.
2005 Lippincott Williams & Wilkins