Related Experiment Video
Updated: Apr 1, 2026
Recognition of Epidermal Transglutaminase by IgA and Tissue Transglutaminase 2 Antibodies in a Rare Case of Rhesus Dermatitis
Published on: December 15, 2011
Factors associated with growth disturbance at celiac disease diagnosis in children: a retrospective cohort study
Samuli Nurminen1,2, Laura Kivelä3,4, Juha Taavela5
1School of Medicine, University of Tampere, FIN-33014, Tampere, Finland. nurminen.samuli.j@student.uta.fi.
Insights
Young age and severe symptoms are key factors in growth disturbance for children with celiac disease (CD). Children with only poor growth present differently, suggesting distinct underlying causes.
Area of Science:
- Pediatric Gastroenterology
- Celiac Disease Research
- Growth and Development
Background:
- Impaired growth is a known complication of celiac disease (CD), but its associated factors require further investigation.
- Understanding these factors is crucial for timely diagnosis and intervention in pediatric CD cases.
Purpose of the Study:
- To identify factors associated with growth disturbance at diagnosis in a large cohort of children with celiac disease.
- To compare clinical and histological characteristics between children with and without growth failure.
Main Methods:
- A cohort of 530 children with biopsy-proven celiac disease was analyzed.
- Participants were categorized based on the presence or absence of growth disturbance at diagnosis.
- Histological, serological, and clinical data were compared between groups.
Main Results:
- Younger age (<3 years), severe villous atrophy, and severe symptoms were significantly associated with growth failure.
- Diagnosis timing and vomiting were also linked to growth disturbance, while abdominal pain showed a protective association.
- Children with poor growth as the sole symptom differed significantly in age and serological markers compared to those with additional symptoms.
Conclusions:
- Young age and severe clinical/histological presentation are strongly linked to growth disturbance in pediatric celiac disease.
- The distinct characteristics of children with isolated poor growth suggest potentially different pathogenic mechanisms compared to those with concomitant symptoms.
Background:
Impaired growth is a well-known complication in celiac disease, but factors associated with it are poorly known. We investigated this issue in a large cohort of children.
Methods:
530 children with biopsy-proven celiac disease were included. The participants were divided into two groups on the basis of the presence (n = 182) or absence (n = 348) of growth disturbance at diagnosis. Histological, serological and clinical characteristics were compared between children with growth failure and those with normal growth. Further, patients with growth failure as the sole clinical presentation were compared to those with poor growth and concomitant other symptoms.
Results:
Children with growth failure were younger (p < 0.001) and had lower hemoglobin (p = 0.016) and higher celiac antibody (p < 0.001), alanine aminotransferase (p = 0.035) and thyroid-stimulating hormone values (p = 0.013) than those with normal growth. Significantly associated with growth failure at diagnosis were age <3 years (OR 4.3 (95 % CI 2.5-7.5) vs older age), diagnosis before the year 2000 and in 2000-09 (OR 3.1 (1.8-5.4) and OR 1.8 (1.1-2.8) vs diagnosis in 2010-2013), presence of total and subtotal villous atrophy (OR 4.2 (2.5-7.0) and OR 2.0 (1.3-3.2) vs partial atrophy), severe symptoms (OR 3.4 (1.8-6.7) vs mild symptoms) and vomiting (OR 3.1 (1.5-6.3). The presence of abdominal pain reduced the risk (OR 0.5 (0.3-0.7)), while there was no effect of gender, diarrhea, constipation, other chronic diseases and celiac disease in the family. Children evincing poor growth as the sole clinical presentation were older (p < 0.001) and had higher hemoglobin (P < 0.001) and total iron (p = 0.010) values and lower TG2ab values (p = 0.009) than those with growth disturbance and other symptoms.
Conclusions:
In particular young age and severe clinical and histological presentation were associated with growth disturbance at celiac disease diagnosis. Children with only poor growth are markedly different from those with other concomitant symptoms, suggesting different pathogenic mechanisms.
Related Concept Videos
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:30Other Disorders of Digestive System
01:10Nature and Nurture
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:30Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are: