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

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.