Ask Dr. Weir – May 2021

This month’s “Ask the Expert” features Dr. Dascha Weir, MD, Associate Director, The Celiac Disease Program, Boston Children’s Hospital. Dr. Weir answers questions about testing siblings for celiac disease and other health monitoring issues.

Question – My 6 year-old was diagnosed with celiac disease 2 years ago. He does great on the gluten-free diet and his health and growth have improved so much. My 1 year-old is showing some of the same symptoms we saw with my older child before his diagnosis. Should I have my 1 year-old tested for celiac disease?

Dr. Weir –  Siblings of children with celiac disease are at higher risk of developing celiac disease. Because of this risk, all siblings of children with celiac disease should be screened with blood work (a total IgA and tissue transglutaminase IgA) at the time of their brother/sister’s diagnosis.  Repeat testing every 3 years through childhood and adolescence is then advised. Typically, we don’t recommend sending the blood work until after the age of 2 years.  However, when a sibling is showing concerning signs or symptoms sooner than 3 years from the last screening tests or before 2 years of age, we recommend screening for celiac disease at that time.  Remember, if a child isn’t consuming gluten regularly, these tests may not show up with positive results even in the setting of celiac disease. 


Question –  Are there other health issues closely related to celiac disease that I should be asking my pediatrician to monitor for in my child?

Dr. Weir –
Pediatricians and gastroenterologists work as a team to promote health and monitor for problems in the children in their care.   There are some specific health issues that we see more frequently in children with celiac disease though, fortunately, most kids won’t develop them. Children with celiac disease are at risk of developing other autoimmune diseases, such as thyroid conditions and type 1 diabetes. Research has also suggested that children with celiac disease have increased risk of psychiatric issues such as depression, anxiety, eating disorders and behavioral disorders. It is important to pay close attention to both the physical and mental health of all children, but especially kids who have celiac disease. 

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