Growth Retardation in Children with Celiac Disease

Cristina      Meazza; Pagani      Sara; Giovenale      Diletta; Kamilia      Laarej; Bozzola      Mauro

Abstract

Celiac disease (CD) is a permanent intolerance to gluten that results in damage of the small intestinal mucosa, and it is one of the common causes of chronic malabsorption in Caucasian children. In CD children, short stature could be the only presenting clinical feature, even in absence of gastroinstestinal symptoms. Generally, withdrawal of gluten from the diet leads to a rapid catch-up growth of body weight within 6-12 months, whereas the height catches up more gradually. A degree of dysfunction of the endocrine axis could be observed in children with CD, but the pituitary function usually normalized after the institution of gluten-free diet. On the other hand, it has been previously reported some patients with isolated and multiple GH deficiency (GHD) showing no catch-up growth during a gluten-free diet, in spite of reversion to seronegativity for EMA. These patients could benefit from substitutive GH therapy as idiopathic GHD ones. This review deals with the problem of linear growth in CD children and points to the importance of the evaluation of GH secretion in those children who showed no catch-up growth after the introduction of gluten-free diet in order to start a GH replacement therapy whether GHD is documented.

Keywords: Celiac disease, short stature, growth hormone, growth hormone deficiency, anti-endomysial antibodies, glutenfree diet

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