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Short children with impaired growth hormone secretion. Do they have celiac disease?
1Pediatric Gastroenterology Unit, Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. E-mail. osaadah@kau.edu.sa.
Insights
A study found that 13.4% of children with growth hormone deficiency (GHD) showed celiac disease (CeD) seropositivity, with 4% confirmed by biopsy. Early CeD detection in GHD patients is crucial for potential growth improvement on a gluten-free diet.
Area of Science:
- Pediatric Endocrinology
- Gastroenterology
- Genetics
Background:
- Short stature (SS) and growth hormone deficiency (GHD) are common pediatric endocrine disorders.
- Celiac disease (CeD) is an autoimmune disorder triggered by gluten ingestion.
- The association between SS/GHD and CeD requires further investigation.
Purpose of the Study:
- To determine the prevalence of celiac disease (CeD) in children diagnosed with short stature (SS) and growth hormone deficiency (GHD).
Main Methods:
- Retrospective analysis of medical records for patients diagnosed with isolated SS and GHD between 2002 and 2016.
- Review of serum tissue transglutaminase (tTG) antibody results.
- Confirmation of CeD diagnosis through upper gastrointestinal endoscopy and small bowel biopsy for patients with positive serology.
Main Results:
- Out of 351 patients with GHD, 13.4% (47/351) had positive CeD serology.
- Biopsy-proven celiac disease (CeD) was confirmed in 4% (14/351) of patients.
- No significant predictors for CeD were identified in children with GHD.
Conclusions:
- A notable prevalence of CeD seropositivity (13.4%) and confirmed CeD (4%) exists in children with GHD.
- The presence of GHD should prompt investigation for CeD.
- Treatment with a gluten-free diet (GFD) may improve growth outcomes in children with co-existing GHD and CeD.
Objectives:
To determine the prevalence of celiac disease (CeD) in children with short stature (SS) and growth hormone deficiency (GHD).
Methods:
This is a retrospective study of patients with isolated SS and GHD, diagnosed during the period 2002 to 2016. Their medical records were reviewed and serum tissue transglutaminase (tTG) antibody results retrieved. Patients with positive serology results underwent upper gastrointestinal endoscopy and small bowel biopsy to confirm the diagnosis of CeD. Clinical, anthropometric, and laboratory data were recorded for all patients.
Results:
Of the 351 patients identified with GHD, 199 (56.7%) were male. The mean age±SD was 9.0±3.7 years (range: 2-17.6 years), and the mean±SD height-for-age z score was -2.9±1.3. Partial GHD constituted 42.2% and severe GHD constituted 57.8% of GHD diagnoses. The mean growth hormone (GH) peak level was 5.8±3.9 ng/ml. Forty-seven patients (13.4%) had positive serology, and 14 (4%) had biopsy-proven CeD. No predictors could be identified through binary logistic regression analysis.
Conclusion:
A prevalence of CeD seropositivity was found in 13.4% and overt CeD in 4% of children with GHD. The finding of GHD should not preclude the search for CeD, because the majority will potentially improve on a gluten-free diet (GFD).
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