Background: Celiac is a common multisystem autoimmune DISEASE with prevalence of about 1%. For every recognized case of celiac DISEASE, 8 more remain undiagnosed. Asymptomatic or minimally symptomatic celiac DISEASE is probably the most common form of the DISEASE, especially in older children and adults. Celiac DISEASE is no longer a disorder limited to childhood and adolescence; it has even been diagnosed for the first time in elderly patients. Infants and young children typically present with chronic diarrhea, anorexia, abdominal distension, abdominal pain, poor weight gain or weight loss, and vomiting. Severe malnutrition can occur if the diagnosis is delayed. Behavioral changes are common and include irritability and an introverted attitude. Rarely, severely affected infants present with a celiac crisis, which is characterized by explosive watery diarrhea, marked abdominal distension, dehydration, hypotension, and lethargy, often with profound electrolyte abnormalities, including severe hypokalemia. Older children with celiac DISEASE who present with GI manifestations may have onset of symptoms at any age. GI symptoms in older children are typically less evident and include nausea, recurrent abdominal pain, bloating, constipation and intermittent diarrhea. Because of the myriad and frequently enigmatic presentations of celiac DISEASE, the challenge of diagnosis falls squarely on the shoulders of primary care practitioners. In infants and toddlers, GI symptoms and FTT predominate, whereas, during childhood, minor GI symptoms, inadequate rate of weight and height gain, and delayed puberty tend to be more common. In teenagers and young adults, anemia is the most common form of presentation. In adults and in the elderly, GI symptoms are more prevalent, although they are often minor. The main extraINTESTINAL manifestations of celiac DISEASE are as follows: dermatitis herpetiformis, dental enamel hypoplasia, aphthous ulcers, delayed tooth eruption, Iron-deficiency anemia, short stature and delayed puberty, chronic hepatitis and hypertransaminasemia, arthritis and arthralgia, osteopenia and osteoporosis, neurological problems, psychiatric disorders (autism, attention deficit hyperactivity disorder), subfertility or infertility. Celiac DISEASE is also known to be strongly associated with numerous disorders, specifically with autoimmune conditions and genetic syndromes.