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Diagnosis of Celiac disease? Celiac disease is a gluten-sensitive enteropathy induced in genetically susceptible individuals through exposure to the gliadin fraction of gluten contained in wheat, rye, barley and oats. The classical clinical presentation of celiac disease in children includes diarrhea, irritability, impaired growth and under nutrition because of maldigestion and malabsorption. A survey of adults and children by the Canadian Celiac Association demonstrated that less than 75% of patients presented with classical symptoms. The majority of children with celiac disease were first diagnosed as having gastroenteritis or food allergy. The diagnosis in children may be made any time after the introduction of gluten to the child's diet. Infant cereals are usually the first gluten containing products to which children are exposed, somewhere between 4-6 months of age. Small bowel biopsy remains the gold standard for the diagnosis of celiac disease; however serological markers now provide a simple and non-invasive initial screening test. The most recent and to date the most accurate serological marker is antiendomysial antibody. Reference:
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