biostudies-literatureSingh ANIDDK NIH HHS698-702https://www.ebi.ac.uk/biostudies/studies/S-EPMC10872809biostudies-literatureUnknown77(6)Gluten challenge is an essential clinical tool that involves reintroducing or increasing the amount of gluten in the diet to facilitate diagnostic testing in celiac disease (CD). Nevertheless, there is no consensus regarding the applications of gluten timing, dosing, and duration in children. This review aims to summarize the current evidence, discuss practical considerations, and proposes a clinical algorithm to help guide testing in pediatric patients. Childhood development, social circumstances, and long-term health concerns must be considered when identifying a candidate for gluten challenge. Based on previous studies, the authors suggest baseline serology followed by a minimum of 3-6 grams of gluten per day for over 12 weeks to optimize diagnostic accuracy for evaluation of CD. A formJournal of pediatric gastroenterology and nutritionA Clinician's Guide to Gluten Challenge.PMC10872809K23 DK119584K23 DK122127Silvester JASparks BLeonard MMKleinhenz JVerma RSingh AFahey LLee DBrill HMallon DfalseA Clinician's Guide to Gluten Challenge.Gluten challenge is an essential clinical tool that involves reintroducing or increasing the amount of gluten in the diet to facilitate diagnostic testing in celiac disease (CD). Nevertheless, there is no consensus regarding the applications of gluten timing, dosing, and duration in children. This review aims to summarize the current evidence, discuss practical considerations, and proposes a clinical algorithm to help guide testing in pediatric patients. Childhood development, social circumstances, and long-term health concerns must be considered when identifying a candidate for gluten challenge. Based on previous studies, the authors suggest baseline serology followed by a minimum of 3-6 grams of gluten per day for over 12 weeks to optimize diagnostic accuracy for evaluation of CD. A form2023-01-01T00:00:00Z2023 Dec2025-04-18T16:00:35.714Z2025-04-07T02:57:22.173ZS-EPMC108728093760843910.1097/MPG.000000000000392310.1097/mpg.0000000000003923