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Growth hormone treatment in prepubertal children with celiac disease and growth hormone deficiency

Diletta Giovenale1, Cristina Meazza, Giuliana M Cardinale

  • 1Department of Pediatric Science, Università degli Studi di Pavia, Fondazione IRCCS San Matteo, Pavia, Italy.

Journal of Pediatric Gastroenterology and Nutrition
|November 22, 2007
PubMed

Insights

Growth hormone (GH) therapy effectively promotes catch-up growth in children with celiac disease (CD) and GH deficiency (GHD) on a gluten-free diet. The treatment

Area of Science:

  • Pediatric Endocrinology
  • Gastroenterology
  • Metabolic Disorders

Background:

  • Celiac disease (CD) can be associated with growth hormone deficiency (GHD), impacting linear growth in children.
  • Adequate gluten-free diet (GFD) adherence is crucial for managing CD but may not always restore normal growth in GHD patients.
  • Evaluating growth response to GH therapy in CD with GHD is essential for optimizing treatment strategies.

Purpose of the Study:

  • To assess the efficacy of growth hormone (GH) replacement therapy in prepubertal children with celiac disease (CD) and GH deficiency (GHD).
  • To compare the growth response in CD/GHD patients on a gluten-free diet with those having idiopathic GHD (IGHD).

Main Methods:

  • A cohort of 14 prepubertal children with CD and GHD, unresponsive to GFD alone, were studied.
  • 10 age-matched children with idiopathic GHD (IGHD) served as a control group.
  • All participants received a standardized weekly dose of GH (0.25 mg/kg) for three years, with regular monitoring of height, growth rate, and BMI.

Main Results:

  • GH therapy significantly increased growth rates in the first year for both CD/GHD and IGHD groups (P < 0.005).
  • Growth rates remained positive in the third year, indicating sustained catch-up growth in both cohorts.
  • The growth response to GH treatment was comparable between children with CD/GHD on a GFD and those with IGHD.

Conclusions:

  • GH replacement therapy is recommended for children with CD and GHD who do not achieve catch-up growth on a gluten-free diet.
  • GH treatment demonstrates comparable efficacy in promoting growth in CD/GHD patients adhering to a GFD as in IGHD patients.
  • This suggests that GH therapy is a viable option for optimizing growth outcomes in this specific pediatric population.
Abstract

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