Content Summary : Celiac disease is an immune-mediated enteropathy caused bya permanent sensitivity to gluten in genetically susceptible in-dividuals. It occurs in children and adolescents with gastroin-testinal symptoms, dermatitis herpetiformis, dental enameldefects, osteoporosis, short stature, delayed puberty and persis-tent iron deficiency anemia and in asymptomatic individualswith type 1 diabetes, Down syndrome, Turner syndrome, Williamssyndrome, selective immunoglobulin (Ig)A deficiency and firstdegree relatives of individuals with celiac disease. The CeliacDisease Guideline Committee of the North American Societyfor Pediatric Gastroenterology, Hepatology and Nutrition hasformulated a clinical practice guideline for the diagnosis andtreatment of pediatric celiac disease based on an integration ofa systematic review of the medical literature combined withexpert opinion. The Committee examined the indications for testing, the valueof serological tests, human leukocyte antigen (HLA) typing andhistopathology and the treatment and monitoring of childrenwith celiac disease. It is recommended that children and ado-lescents with symptoms of celiac disease or an increased riskfor celiac disease have a blood test for antibody to tissuetransglutaminase (TTG), that those with an elevated TTG bereferred to a pediatric gastroenterologist for an intestinal biopsyand that those with the characteristics of celiac disease onintestinal histopathology be treated with a strict gluten-freediet. This document represents the official recommendations ofthe North American Society for Pediatric Gastroenterology,Hepatology and Nutrition on the diagnosis and treatment ofceliac disease in children and adolescents. JPGN 40:1–19,2005.