IngentaConnect Growth hormone deficiency and coeliac disease: an unusual associa...

Authors: Bozzola, Mauro¹; Giovenale, Diletta¹; Bozzola, Elena¹; Meazza, Cristina¹; Martinetti, Miryam²; Tinelli, Carmine³; Corazza, Gino Roberto⁴

Source: Clinical Endocrinology, Volume 62, Number 3, March 2005 , pp. 372-375(4)

Publisher: Blackwell Publishing

Abstract:

Summary Objective

To assess the occurrence of growth hormone deficiency (GHD) in patients with coeliac disease (CD). Study Design

A total of 1066 children diagnosed elsewhere with short stature were referred to our centre for second-line evaluation in a 6-year period. All patients were screened for CD by antiendomysial antibodies (EMA) and those with positive sera underwent intestinal biopsy. Results

Among the 1066 short children, 210 (19·7%) had GHD and 12 (1·12%; chronological age from 3·6 to 12·3 years, bone age from 1·5 to 10·5 years, SDS height from −3·05 to −0·48), having positive EMA, showed histologically confirmed CD. Nine of these latter 12 CD children had a beneficial effect on growth rate after the first year of gluten-free diet, while the remaining three showed no catch-up growth. A careful endocrinological investigation in these three CD boys showed an isolated GHD in two cases and a multiple GHD in one case. The congenital origin of GHD is supported by the congenital abnormalities documented by magnetic resonance imaging. GH therapy associated with gluten-free diet led to an increased growth rate. Conclusion

GH secretion should be evaluated in coeliac patients showing no catch-up growth after a period on a gluten-free diet in spite of reversion to seronegativity for EMA. In the case of GHD and CD, replacement GH therapy should be started during a gluten-free diet.

Document Type: Research article

DOI: 10.1111/j.1365-2265.2005.02227.x

Affiliations: 1: Pediatric Department, University of Pavia, 2: Immunohematology and Transfusion Center, 3: Biometrics Unit, IRCCS San Matteo and 4: Gastroenterology Unit, University of Pavia, Pavia, Italy

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Growth hormone deficiency and coeliac disease: an unusual association?