Micronutrient deficiencies and celiac disease in Pediatrics Deficiencia de micronutrientes y enfermedad celíaca en pediatría

Celiac disease (CD) is apparently changing in its clinical presentation, from chronic diarrhea and malnutrition to a silent clinic at older ages. The basal enteropathy of CD induces macroand micronutrient malabsorption. Described micronutrient deficiencies in CD include: Fe, Zn, Cu, folate, Ca, vitamin E, D, B12 and B6, with complex transporter mechanisms altered. Ferropenic anemia has been described in CD as the exclusive sign and the most common extraintestinal sign. Zn deficiency is frequent in CD, associated with growth delay and immune alterations. Even though the main basis for vitamin D metabolic status is the activation of subdermal vitamin precursors by sun-UVB rays, the small bowel compromise may affect activity and vitamin D absorption. Pathophysiology of vitamin B12 deficiency in CD is unknown; it must be suspected in CD patients presenting neurological and haematological alterations. Copper deficiency has been described mainly in adult CD patients. Micronutrient deficienc