Should Celiac Disease Screening in Children with Down Syndrome Be Symptom-Based or Universal?

The risk for celiac disease is sixfold higher in children with Down syndrome than in the general U.S. population. The American Academy of Pediatrics (AAP) recommends symptom-based celiac screening, whereas the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition recommends universal screening for those ≥3 years old. To investigate whether children with celiac disease identified by universal screening would have been missed with symptom-based screening only, these authors reviewed records for children ≥3 years old with Down syndrome who were serologically screened for celiac disease at their initial visit to a multidisciplinary Down syndrome center.

Overall, 68 of 691 patients (9.8%) had a diagnosis of celiac disea…