The aim was to determine the prevalence of celiac disease (CD) in a pediatric population with juvenile idiopathic arthritis (JIA) and autoimmune hepatitis (AIH) compared to controls and to evaluate the clinical forms and human leukocyte antigen (HLA) alelles. Between September 2009-November 2019, 74 pediatric patients with JIA (1), 62 AIH (2) and 60 controls were assessed for CD. All children with one or more positive CD antibodies were submitted to gastrointestinal endoscopy with intestinal biopsy. All patients underwent HLA molecular assessment for DQ2/DQ8 alleles. Celiac prevalence after screening was 6.7% in the first group, 6.4% in the second group and 0% among controls. The results didn�t reveal significant differences regarding the CD prevalence among patients with JIA and AIH (p = 0.94). The majority of cases associated the silent form of disease (77.7). DQ2/DQ8 haplotypes were found in all CD cases. Of 69 children with JIA and no CD, three (4.3%) had DQ2 haplotype. Of 58 patients with AIH and no CD, 37 children (63.8%) presented DQ2/DQ8. According to the high prevalence obtained in this study, JIA and AIH are good parameters for stratification of asymptomatic cases in order to perform CD serologic screening. The absence of DQ2 or DQ8 haplotypes will make CD diagnosis unlikely and no further tests will be required.

Proton-Pump Inhibitors (PPIs) represent the major therapeutic tool of gastric acid-related disorders in adults and pediatric patients. The proton pump must be activated before the PPI is cleared from the circulation in order to effectively inhibit the H/K ATPase. This is related to time to reach maximum concentration, the absorption and elimination rate of the drug. All these features are modulated by age and genetics. Prolonged inhibition of gastric acid secretion may cause hypergastrinemia and enterochromaffin-like-cell hyperplasia, nutrients deficiency, necrotizing enterocolitis, atrophic gastritis, intestinal dysbiosis and digestive infections. These potential side effects have been described in adults, but pediatric studies are scarce. This review summarizes the pharmacodynamic features of PPIs and clarifies the side effects mechanisms of PPIs in children and adults.