The Yale Pediatric Celiac Disease Program is a comprehensive, family-centered clinic providing medical and supportive care for children with Celiac disease and gluten-related disorders and their families.
Children in this program will be evaluated for gluten-related disorders and followed from the time of diagnosis of Celiac disease and regular follow-ups until symptoms have resolved and then annually to ensure treatment compliance and normal weight and height gain.
Criteria for referral into the program include children with the following diagnoses and/or conditions:
- Celiac disease, diagnosed via biopsy
- Probable Celiac disease, noted by elevation of Celiac serologic markers
- Possible gluten sensitivity, based on improvement in symptoms on a gluten-free die
- Asymptomatic children with a family history of Celiac disease
- High-risk groups including children with type I Diabetes Mellitus, Down syndrome and IgA deficiency
The primary purpose of the program is to assist the family and child with Celiac disease and other gluten related disorders and to ensure that each child is growing and developing well.
Celiac disease is a common immune mediated disease with an estimated incidence of 1 in 133 people in the general population. It is associated with a permanent gluten intolerance that leads to a variety of symptoms including:
- Poor weight gain
- Short stature
- Abdominal pain
Children with the disease are predisposed genetically with the presence of one or both of the genes associated with Celiac, HLA-DQ2 and HLA-DQ8. Despite the genetic predisposition, it is not uncommon for children to be the first one diagnosed in the family, as family members may not yet be diagnosed.
Currently, the only treatment available is with a gluten-free diet. Children with Celiac disease are at risk for micro-nutrient deficiencies, including iron, and vitamin D. Some of the deficiencies will resolve with adequate treatment and adherence to the gluten free diet. However, the gluten-free diet predisposes individuals with other vitamin deficiencies making adequate and regular follow-up essential.
The pediatric gastroenterologist, nurse coordinator and nutritionist will meet with children and their families at the initial visit or once a diagnosis of Celiac disease is confirmed.
At each visit, Dr. Porto and Kristin Sikes will perform a complete medical visit which includes a medical history, physical examination, and testing as needed. Dana, our Celiac nutritionist, will evaluate the child and home environment and assess nutrition status, possible areas of cross-contamination as well as provide parent education. The nurse coordinator will direct clinic flow among the multidisciplinary team members as well as provide education and coordinate services with other specialty providers and community resources. Referrals to sub-specialists will be made on an individualized basis.
Program Services Include:
- Celiac Genetic Testing via cheek swab or blood test as indicated
- Coordination of sub-specialist care
- Nutritional evaluation and education
- Social work assessment and assistance
- Referrals for intervention and community services including local support groups
- Same day appointments for children with Celiac disease and type I diabetes with the Celiac and diabetes team
Medical Director: Anthony F. Porto, MD, MPH
Nurse Practitioner: Kristin Sikes, APRN
Nurse Coordinator: Jesenia Galarza, RN, BSN
Clinical Dietitian: Nicole Hermosilla, RD, CNSC