The authors review some unsolved and controversial problems of pathogenesis, serologic and morphologic diagnosis, and also the clinical features and therapy of the celiac disease in children. The problems of toxicity of various cereals in celiac disease, possible pathogenetic mechanisms that determine its extremely polymorphous clinical features, causes of the increasing spread and changes of clinical symptoms in the past decades, modern approaches to diagnosing this disease are discussed. The importance of early morphological investigation of the mucous membrane of the small intestine for objective diagnosis is stressed. The issues of diet therapy as the basic method of treating the celiac disease are discussed in detail, medical and socioeconomic problems of keeping gluten-free diet are pointed out.

In allergic enteropathy (gastrointestinal form of food allergy) in children, clinical symptoms can be often observed similar to the signs of celiac disease (persistent diarrhea and other dyspeptic symptoms, nutritive insufficiency), sensitization to gluten and a number of other food allergens, yet the prognosis for these diseases will be different. In order to specify the differential-diagnostic criteria of the latter, 38 children with allergic enteropathy and 72 patients with celiac disease were examined at various terms of their observance of gluten-free diets. The main differential-diagnostic criterion of allergic enteropathy as compared with celiac disease might be the absence of the dynamics of morphometric parameters of the mucous membrane of the small intestine and antibody titers to gluten depending on the presence or absence of gluten in the diet. Several months after administering a gluten-free diet a differential diagnosis of either allergic enteropathy or celiac disease will be difficult to make, in some cases, however, it is possible with the help of an analysis of morphometric indices of the mucous membrane considering the duration of dieting