Celiac disease is a chronic autoimmune condition where consuming gluten—a protein found in wheat, barley, rye, and sometimes oats—triggers an immune response that damages the lining of the small intestine. Over time, this damage interferes with nutrient absorption, leading to various health problems.
Celiac disease is associated with specific genetic markers, particularly HLA-DQ2 and HLA-DQ8, and tends to run in families. Symptoms vary widely depending on age and disease severity.
• Classic symptoms include chronic diarrhea, abdominal pain, bloating, weight loss in adults, and in children, growth delays.
• Non-classic symptoms might include fatigue, joint pain, skin rash, alopecia, vitiligo, or anemia. Some people have no symptoms at all, but damage to the intestines can still occur.
Diagnosis starts with serological testing for specific autoantibodies. If these tests are positive, a biopsy of the small intestine is often done to confirm the diagnosis.
The only treatment for celiac disease is a strict, lifelong gluten-free diet. This means avoiding foods and drinks containing wheat, barley, rye, and their derivatives. Gluten-free grains like rice, corn, and quinoa are safe to eat and promote intestinal mucosal healing, alleviates symptoms, and significantly improves quality of life.
Because gluten can be hidden in processed foods and medications, reading ingredient labels carefully is essential. A gluten-free diet can be challenging, but with guidance from a healthcare provider or dietitian, most people can successfully manage their condition and improve their quality of life.
It is noteworthy that gluten is not limited to wheat, rye, and barley products but may also be present in a wide range of processed foods and pharmaceutical preparations. Consequently, maintaining a gluten-free diet requires meticulous attention to food labels and product ingredients, making adherence challenging for many patients.
Cystic fibrosis (CF) is a rare genetic disorder that primarily affects the respiratory and digestive systems, as well as other organs, including the reproductive system. In the United States, CF occurs in approximately 1 in 3,500 live births.
This condition is caused by mutations in the CFTR (cystic fibrosis transmembrane conductance regulator) gene. These mutations result in the production of thick, sticky mucus that clogs airways, creating an environment conducive to bacterial and viral infections. Additionally, the mucus impairs pancreatic function, leading to malnutrition and growth delays, particularly in children.
Early recognition of CF is critical for effective management. Common symptoms include:
• Frequent respiratory infections such as bronchitis and pneumonia
• Persistent cough with mucus production
• Chronic diarrhea or greasy stools
• Malabsorption of nutrients, leading to vitamin deficiencies and poor weight gain
• Excessive sweating and salt loss
• In newborns, symptoms may include meconium ileus (bowel obstruction), abdominal bloating, and failure to thrive.
Diagnosis typically involves newborn screening, sweat chloride testing, and genetic analysis. A multidisciplinary team, including specialists such as pulmonologists, gastroenterologists, dietitians, and genetic counselors, develops an individualized treatment plan for each patient.
Treatment focuses on managing symptoms and preventing complications. Key components of care include:
• Respiratory therapies, such as airway clearance techniques and inhaled medications
• Pancreatic enzyme replacement therapy to aid digestion
• Nutritional support, including high-calorie diets and fat-soluble vitamin supplementation
• Antibiotics to control infections
• Regular physical activity to improve lung function
While there is no cure for cystic fibrosis, advances in treatment have significantly improved life expectancy and quality of life for patients. In the mid-20th century, individuals with CF rarely lived beyond 30 years. Today, many patients live into their 50s or beyond, with some reaching their 80s. Continued research and innovative therapies hold promise for further extending life expectancy.
Interstitial lung diseases (ILD) encompass a group of disorders characterized by progressive scarring (fibrosis) of the lung tissue, primarily affecting the interstitium—the tissue surrounding the alveoli, which are the smallest structures in the lungs responsible for gas exchange. The formation of scar tissue impairs lung elasticity and reduces the efficiency of oxygen transfer into the bloodstream. In pediatric cases, these conditions are referred to as Childhood Interstitial Lung Disease (chILD).
The causes of ILD are diverse, with significant contributing factors including environmental and occupational exposures. Polluted air and certain industrial substances, such as heavy metals, chlorine vapor, ammonia, manure, and sugar dust, are particularly harmful to lung tissue. Infectious agents—viral, bacterial, parasitic, or fungal—can also contribute to disease onset, as can autoimmune conditions such as lupus, rheumatoid arthritis, and sarcoidosis. Certain medications, including psychiatric, cardiological drugs, and antibiotics, have been linked to ILD. In some cases, the condition is congenital.
Common symptoms of ILD include:
• Dry cough
• Shortness of breath (dyspnea), which worsens over time
• Fatigue and general weakness
• Rapid or labored breathing
• Digital clubbing (thickening of the fingers and toes)
As the disease progresses, shortness of breath becomes more pronounced and may occur even during minimal activities, such as dressing, speaking, or eating. Other signs may include wheezing, chest pain, and nail or finger deformities.
At Iashvili Children’s Central Hospital, we have extensive experience diagnosing and managing interstitial lung diseases. Our hospital is the only pediatric-focused facility in the country capable of providing comprehensive inpatient care for complications associated with these conditions. Common complications include pulmonary hypertension, which results from damage to the pulmonary arteries; right-sided heart failure (cor pulmonale); and chronic respiratory failure.
Diagnostic evaluations typically include:
• Chest radiography
• Computed tomography (CT) scans
• Spirometry to assess lung function
• Bronchoscopy for visualizing airways and obtaining samples
Treatment is tailored to each patient’s needs and may include both pharmacological and non-pharmacological approaches. These may involve oxygen therapy, respiratory exercises, and physical activity.
Currently, there is no definitive cure for ILD. Treatment aims to slow or halt the progression of lung damage and improve quality of life. The choice of therapy depends on the specific type of ILD and its underlying cause.
At Iashvili Children's Hospital, ambulatory diagnosis and treatment of maxillofacial and soft tissue conditions are highly developed. This department provides comprehensive services for pediatric patients and is staffed by a highly qualified team of dentists and maxillofacial surgeons.
The diagnostics at the clinic are advanced, incorporating both panoramic radiography and computed tomography (CT).
Among the various ambulatory services offered, orthopedic dentistry stands out. Iashvili Children's Hospital performs complex orthopedic prosthetics, providing pediatric patients with optimal solutions, often without the need to travel abroad.
Surgical dentistry is also available on an outpatient basis, including the treatment of impacted teeth, underdeveloped tooth buds, and complex odontogenic pathologies.
In addition, the ambulatory service includes oral surgeries that do not require hospitalization, such as the plastic surgery of salivary gland ducts, the treatment of chronic tongue injuries, papillomavirus, fibromas, ulcers, cysts, and other pathological formations.
The Pulmonary Center specializes in the diagnosis, treatment, and management of various pulmonary pathologies. The involvement of a multidisciplinary team ensures personalized ambulatory services for pediatric patients aged 0 to 18 who require specialized care for congenital, acquired, allergic, and rare pulmonary conditions, as well as tuberculosis and diseases of the thoracic cavity organs. The treatment process includes specialists from various fields (pediatricians, pediatric pulmonologists, phthisiatrists, allergists, pediatric surgeons, endoscopists, and radiologists).
The center successfully manages diseases associated with lung collapse, pleural complications, and acute respiratory failure, as well as acute respiratory infections (acute bronchitis, croup, bronchiolitis), chronic pulmonary diseases (cystic fibrosis, interstitial pneumonia, bronchial asthma), and pulmonary pathologies related to neuro-muscular complications. The center also provides differential diagnosis for suspected tuberculosis cases.
In terms of respiratory system diagnostics, a full spectrum of instrumental and laboratory tests is available, including high-tech and specific examinations, such as:
• Spirometry – assessment of external respiratory function
• Basic allergic testing
• Computed tomography (CT)
• Radiological examinations
• Echocardiographic study of the thoracic cavity
• Endoscopic diagnostics, including bronchoscopy
• Early diagnosis of wheezing using the Wheeze Scan apparatus
• Complete viral panel testing for respiratory system acute infections based on the Lugar Laboratory
Laboratory studies, including bacterial, biochemical, and immunological investigations
