Celiac Disease (CD) is a permanent, irreversible but treatable multifactorial disease triggered by the ingestion of gluten (a plant storage protein contained in wheat, barley and rye) in genetically predisposed individuals and resulting in an autoimmune small intestinal inflammation with systemic implications.

Celiac Disease (CD) is a permanent, irreversible but treatable multifactorial disease triggered by the ingestion of gluten (a plant storage protein contained in wheat, barley and rye) in genetically predisposed individuals and resulting in an autoimmune small intestinal inflammation with systemic implications.


Gluten is a heterogeneous molecule. The gluten fractions that are toxic to celiac patients are a mixture of alcohol-soluble proteins called gliadins. Gliadins are rich in glutamine and proline residues, which even the healthy human intestine cannot fully digest. As a result, intact gliadin peptides are left in the lumen, and some cross the intestinal barrier. These fragments come into contact with the intracellular enzyme tissue transglutaminase (tTG), which deamidates them, leading to a change in shape and increased negative charge. This creates peptides that can easily be captured by the HLA-DQ2 and/or DQ8 molecules expressed on the surface of the lamina propria-associated antigen-presenting cells (APCs) and are presented to CD4⁺ T cells triggering an inflammatory reaction [5].

Typical and atypical forms of Celiac Disease (from Ref. [7]).

Sign or symptom	Age most commonly involved
Typical Celiac Disease
Vomiting	Infancy
Anorexia	Infancy to early childhood
Failure to thrive	Infancy to early childhood
Diarrhea	All ages
Abdominal bloating	All ages
Abdominal pain	Child to adult
Constipation	Child to adult
Weight loss	Child to adult
Atypical Celiac Disease
Sad mood	Infancy to early childhood
Elevated AST, ALT	All ages
Fatigue	All ages
Delayed puberty	Adolescent
Short stature	Child to adult
Anemia	Child to adult
Dermatitis Herpetiformis	Adolescent to adult
Dental enamel defects	Child to adult
Oral aphthae	Child to adult
Arthritis	Child to adult
Osteopenia	Adolescent to adult
Osteoporosis	Adult
Unexplained infertility	Adult
Headaches/migraine	Adolescent to adult
Peripheral Neuropathy	Adult
Idiopathic seizures	Child to adult
Psychiatric disorders	Adolescent to adult

Individuals at increased risk for Celiac Disease (From Ref. [7]).

• Subjects with signs and symptoms of Table 1 otherwise unexplained

• First degree relatives of celiac patients

• Autoimmune conditions

◦ Type 1 diabetes

◦ Autoimmune thyroiditis

◦ Autoimmune hepatitis

◦ Addison disease

• Genetic disorders

◦ Down syndrome

◦ Turner syndrome

◦ Williams syndrome

◦ IgA deficiency The proposed diagnostic algorithm allowed skipping the duodenal biopsy under certain circumstances: namely, in children and teenagers showing a history and genetic asset compatible with CD, tTG-IgA levels >10 times the upper limit of normal and a positive titer of endomysial antibody (EMA) [11]. Recommendations for follow-up of celiac children. Test At diagnosis At 3–6 months At 1 year and yearly thereafter EMA ○ TTG-IgA ○ ○ ○ DGP-IgG ○ ○ ○ CBC ○ ○ ○ Fe studies ○ TSH + T4 ○ ○ Vitamin D ○ Dietitian review ○ ○ ○

My favorite physics teacher answered almost every question "Maybe yes; and maybe no."

My favorite physics teacher answered almost every question "Maybe yes; and maybe no."

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Nearly half of the Earth's original forest cover has already been lost. Each minute 85 acres of forest are destroyed — globally more than 32 million acres are lost each year

Nearly half of the Earth's original forest cover has already been lost.

Each minute 85 acres of forest are destroyed — globally more than 32 million acres are lost each year

White men who exercise at high levels are 86 percent more likely than people who exercise at low levels to experience a buildup of plaque in the heart arteries by middle age, a new study suggests.

White men who exercise at high levels are 86 percent more likely than people who exercise at low levels to experience a buildup of plaque in the heart arteries by middle age, a new study suggests.


High levels of exercise over time may cause stress on the arteries leading to higher CAC," said Rana, "however this plaque buildup may well be of the more stable kind, and thus less likely to rupture and causes heart attack, which was not evaluated in this study." Rana says they plan to evaluate for outcomes, such as heart attacks and death, next.

Raising the retirement age for Social Security should save money, but it just brings older, sicker people into the system.

Raising the retirement age for Social Security should save money, but it just

brings older, sicker people into the system.

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