Poster #009, UCSF Benioff Children's Hospital Oakland
Association of Toxic Metal Levels and Anxiety in Pediatric Celiac Disease Patients on a Gluten Free Diet
Mentors: Mala Setty, MD & David Killilea, PhD
A strict, lifelong gluten-free diet (GFD) is the primary treatment for pediatric Celiac Disease (CD). However, GFD adherence introduces overlooked physical and psychological risks. Gluten-free grain substitutes rely heavily on rice, which accumulates toxic elements like arsenic and cadmium from soil. Chronic exposure to these elements, alongside altered zinc and copper statuses, may impair intestinal stem cell function and mucosal recovery in an already inflamed gut. Simultaneously, navigating strict dietary restrictions, fear of cross-contamination, and social isolation places a chronic psychological burden on pediatric patients, triggering heightened anxiety. This study at the UCSF Benioff Children’s Hospital Outpatient Clinic utilizes a parallel, mixed-methods clinical design to investigate these dual realities. Biologically, we non-invasively collect head hair and fingernail clippings, which act as a long-term archive of elemental exposure compared to transient blood tests. Following rigorous washing and acid digestion, we quantify toxic elements (such as arsenic and cadmium) and nutritional minerals (such as zinc and copper) using Inductively Coupled Plasma Optical Emission Spectroscopy (ICP-OES) and Mass Spectrometry (MS). Psychologically, we are executing a quality improvement initiative to integrate validated physical anxiety screeners (such as the GAD-7) directly into routine gastroenterology clinical workflows. We anticipate finding positive correlations between GFD duration, elevated heavy metal tissue concentrations, and increased clinical anxiety scores. Ultimately, this work provides a critical baseline to optimize future regenerative therapies and justifies establishing routine toxicological and psychological tracking as a comprehensive standard of care for pediatric Celiac patients.