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Growth hormone deficiency and coeliac disease: an unusual association?

Mauro Bozzola1, Diletta Giovenale, Elena Bozzola

  • 1Pediatric Department, University of Pavia, Pavia, Italy. m.bozzola@smatteo.pv.iy

Clinical Endocrinology
|February 26, 2005
PubMed

Insights

Growth hormone deficiency (GHD) occurs in some children with coeliac disease (CD). Evaluating GH secretion is crucial for coeliac patients with poor growth on a gluten-free diet, with GH therapy beneficial alongside dietary changes.

Area of Science:

  • Pediatric Endocrinology
  • Gastroenterology
  • Genetics

Background:

  • Short stature is a common concern in pediatric endocrinology.
  • Coeliac disease (CD) is an autoimmune disorder triggered by gluten ingestion.
  • The relationship between CD and growth hormone deficiency (GHD) requires further investigation.

Purpose of the Study:

  • To determine the prevalence of GHD in children diagnosed with short stature.
  • To investigate the incidence of coeliac disease in this cohort.
  • To assess the impact of gluten-free diet and growth hormone therapy on growth in children with both conditions.

Main Methods:

  • A cohort of 1066 children with short stature underwent evaluation.
  • Screening for CD included antiendomysial antibodies (EMA) and intestinal biopsy.
  • Patients diagnosed with CD were monitored for growth response to a gluten-free diet and, in some cases, growth hormone (GH) therapy.

Main Results:

  • Of 1066 children, 19.7% had GHD. Twelve children (1.12%) were diagnosed with CD.
  • Nine of the 12 CD children showed improved growth on a gluten-free diet.
  • Three CD children did not experience catch-up growth, with two diagnosed with isolated GHD and one with multiple GHD, benefiting from GH therapy.

Conclusions:

  • Growth hormone secretion should be assessed in coeliac patients who do not achieve catch-up growth on a gluten-free diet.
  • Growth hormone replacement therapy should be initiated in children with coeliac disease and GHD while adhering to a gluten-free diet.
  • Congenital GHD may be associated with CD, as suggested by MRI findings.
Abstract

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