Celiac disease (CD) is an immune-mediated systemic disease triggered by the intake of gluten in genetically susceptible individuals. The prevalence of CD in the general population is estimated to be 1% worldwide. Its prevalence varies depending on geographical and ethnic factors. The prevalence of CD has increased significantly in the last 30 years due to the increased knowledge and awareness of physicians and the widespread use of highly sensitive and specific diagnostic tests for celiac disease. Despite increased awareness and knowledge about CD, up to 95% of patients with celiac disease still remain undiagnosed.

The diagnosis of CD is difficult because symptoms vary from patient to patient. However, the presentation of the disease has significantly changed in the last few decades. Classical symptoms of CD occur in a minority of patients, while older children have either minimal or atypical symptoms.

Serologic tests for CD should be done in patients with unexplained chronic or intermittent diarrhea, failure to thrive, weight loss, delayed puberty, short stature, amenorrhea, iron deficiency anemia, nausea, vomiting, chronic abdominal pain, abdominal distension, chronic constipation, recurrent aphthous stomatitis, and abnormal liver enzyme elevation, and in children who belong to specific groups at risk.

Celiac disease is diagnosed by a variable combination of symptoms, positive celiac antibodies, presence of HLA-DQ2/DQ8, and duodenal histology. ESPGHAN guidelines from 2020 recommend that the diagnosis of CD can be made with tissue transglutaminase antibody levels above 10 times the ULN and anti-endomysial antibody positivity in a second blood sample. Early diagnosis of CD is very important to prevent long-term complications. Currently, the only effective treatment is a lifelong gluten-free diet.

This Research Topic will be open for original research articles, case reports, as well as review articles focusing on several aspects of pediatric celiac disease. We invite global leading experts in the field of celiac disease, including those conducting epidemiological research, basic research, translational research, and clinical research, to contribute original manuscripts describing innovative methods, techniques, findings, and perspectives.

Potential topics include but are not limited to the following:

• Epidemiology of celiac disease
• Pathogenesis of celiac disease
• Extra-intestinal manifestations of celiac disease
• Nutritional assessment of celiac disease
• Bone mineral density in celiac disease
• No-biopsy approach in celiac disease
• Follow-up of celiac disease
• Management

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Frontiers in Pediatrics

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