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Clinical Medicine & Research
Volume 4, Number 3 : 180 -183
doi:
© 2006 Marshfield Clinic
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Original Research

The Prevalence of Growth Hormone Deficiency and Celiac Disease in Short Children

Diletta Giovenale, MD, Cristina Meazza, PhD, Giuliana M. Cardinale, MD, Maddalena Sposito, MD, Costanzo Mastrangelo, MD, Beatrice Messini, MD, Giuseppe Citro, MD, Maurizio Delvecchio, MD, Salvatore Di Maio, MD and Mauro Bozzola, MD

Diletta Giovenale, MD, Dipartimento di Scienze Pediatriche, Università degli Studi di Pavia, IRCCS Policlinico San Matteo, Pavia, Italy
Cristina Meazza, PhD, Dipartimento di Scienze Pediatriche, Università degli Studi di Pavia, IRCCS Policlinico San Matteo, Pavia, Italy
Giuliana M. Cardinale, MD, Divisione di Pediatria, Ospedale "F. Ferrari", Casatano, Lecce, Italy
Maddalena Sposito, MD, Clinica Pediatrica Monteluce, Perugia, Italy
Costanzo Mastrangelo, MD, U.O. Pediatria, Ospedali Riuniti, Foggia, Italy
Beatrice Messini, MD, U.O. Pediatrica, Ospedale di Foligno, Foligno, Italy
Giuseppe Citro, MD, U.O. Endocrinologica, Ospedale San Carlo, Potenza, Italy
Maurizio Delvecchio, MD, Dipartimento di Biomedicina dell’età evolutiva, Università degli studi di Bari, Bari, Italy
Salvatore Di Maio, MD, Dipartimento di Pediatria e Riabilitazione, Azienda Ospedaliera Pediatrica "Santobono-Pausilipon", Napoli, Italy
Mauro Bozzola, MD, Dipartimento di Scienze Pediatriche, Università degli Studi di Pavia, IRCCS Policlinico San Matteo, Pavia, Italy

Reprint Requests: Mauro Bozzola, MD, Dipartimento di Scienze Pediatriche, Università di Pavia, IRCCS San Matteo, Piazzale C. Golgi 2, 27100 Pavia, Italia. Tel: +39-0382-502891; Fax: +39-0382-527976; E-mail: mauro.bozzola{at}unipv.it

Objectives: To assess the occurrence of growth hormone deficiency (GHD) in patients with celiac disease (CD) referred for short stature.

Design: A retrospective, multi-center study. A total of 7066 children with short stature were referred to a number of centers for second-line evaluation over a 5-year period. All patients were screened for CD by antiendomysial antibodies (EMA) and antitissue transglutaminase IgA.Those with positive sera underwent intestinal biopsy. The EMA-negative patients and the EMA-positive ones who did not grow after 1 year of gluten-free diet underwent endocrinological investigation.

Results: Among the 7066 short children (age 2–14 years) evaluated, 650 (9.2%) had GHD and 44 (0.63%) had CD. An association of both CD and GHD was found in 16 short children (0.23%); these children did not grow after 1 year of gluten-free diet and therefore GH treatment was started.

Conclusions: GH secretion should be evaluated in celiac patients showing no catch-up growth after an appropriate period on a gluten-free diet in spite of reversion to seronegativity for EMA.

Key Words: Antiendomysial antibodies • Celiac disease • Growth hormone deficiency • Prevalence • Short children






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