The prevalence of growth hormone deficiency and celiac disease in short children

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Diletta Giovenale1, Cristina Meazza, Giuliana M Cardinale

  • 1Dipartimento di Scienze Pediatriche, Università degli Studi di Pavia, IRCCS Policlinico San Matteo, Pavia, Italia.

Clinical Medicine & Research
|September 22, 2006
PubMed

Insights

Growth hormone deficiency (GHD) affects 0.23% of short children with celiac disease (CD). Evaluate GHD in celiac patients with poor growth despite a gluten-free diet.

Area of Science:

  • Pediatric endocrinology
  • Gastroenterology
  • Genetics

Background:

  • Short stature is a common referral reason for pediatric endocrinology evaluation.
  • Celiac disease (CD) is an autoimmune disorder triggered by gluten, potentially impacting growth.
  • Growth hormone deficiency (GHD) is a significant cause of short stature.

Purpose of the Study:

  • To determine the prevalence of GHD in children with celiac disease presenting with short stature.
  • To investigate the association between CD and GHD in this cohort.

Main Methods:

  • Retrospective, multi-center study of 7066 children with short stature (ages 2-14).
  • Screening for CD using antiendomysial antibodies (EMA) and antitissue transglutaminase IgA, followed by biopsy if positive.
  • Endocrinological investigation for GHD in EMA-negative patients and EMA-positive patients with inadequate growth on a gluten-free diet.

Main Results:

  • Out of 7066 children, 9.2% had GHD and 0.63% had CD.
  • A combined diagnosis of CD and GHD was identified in 16 children (0.23%).
  • These 16 children did not exhibit catch-up growth after one year of a gluten-free diet, leading to initiation of growth hormone treatment.

Conclusions:

  • Growth hormone secretion assessment is recommended for celiac disease patients who do not achieve catch-up growth on a gluten-free diet.
  • Even with serological normalization (EMA reversion), persistent poor growth warrants further investigation for GHD in CD patients.
Abstract

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