Foreword

Article Outline

• Copyright

In this issue, Dr. M. Luisa Mearin from the Department of Pediatrics at the Leiden University Medical Center and Free University Medical Center, Amsterdam, The Netherlands, provides a review of celiac disease among children and adolescents. Celiac disease, also known as celiac sprue, nontropical sprue, and gluten-sensitive enteropathy, is much more common in the United States than previously thought. Recent estimates are that 1 in 133 people in the United States have celiac disease, and the incidence may be as high as 1 in 22 among those with a first degree relative with the disease. The “textbook” presentation with failure to thrive, malabsorption, and chronic diarrhea may be seen in young children, but older children and adults often present with extra-intestinal symptoms such as anemia, delayed puberty, depression, migraines, fatigue and non-specific arthritis.

Even though it is commonly thought of as a childhood disease, celiac disease is now more frequently diagnosed in adults than children. Women with undiagnosed celiac disease are at higher risk for infertility and recurrent abortions and their children may have a higher risk of neural tube defects. This is yet another reason that all women of child bearing age should follow the United States Public Health Service recommendation to take 400 micrograms of folic acid a day, whether they intend to become pregnant or not. In 2007, 15 years after that recommendation was announced, the majority of women of childbearing age in the United States still do not take a vitamin containing folic acid daily. We as health professionals should do more to promote preconceptional health among all women of childbearing age, and encourage them to take a vitamin containing folic acid daily.