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A Journal on Endocrine System Diseases

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Minerva Endocrinologica 2015 Oct 23

A retrospective evaluation of the association of celiac disease and growth hormone deficiency: more than a casual association?

Giannattasio A. 1, 2, Di Dato F. 1, Minicucci V. 2, Mariano M. 2, Spagnuolo M. I. 1, Macchiaroli A. 3, Iorio R. 1

1 Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy;
2 Medicine and Health Sciences Department, University of Molise, Campobasso, Italy;
3 Pediatric Endocrinology Reference Center, Ospedale Cardarelli, Campobasso, Italy

BACKGROUND: A transient dysfunction of the endocrine growth axis has been reported in celiac disease (CD). This apparent growth hormone (GH) deficiency (GHD) generally normalizes with the institution of a gluten-free diet (GFD). However, in few cases, the dysfunction of the GH axis persists despite a good adherence to the GFD. Aims of this study were to investigate pediatric patients with concurrent CD and GHD and to compare them with patients with isolated CD.
METHODS: Data of CD patients with and without associated GHD were retrospectively collected. Inclusion criteria were availability of anthropometric and laboratory data at baseline and regularly at the reference center up to a 2-year follow-up. In case of poor catch-up growth despite a good adherence to the GFD, endocrinological investigation was carried on.
RESULTS: Fifty-three patients with CD were included. Four (7.5%) out of 53 CD patients had a concurrent GHD. In two cases, firstly diagnosed with CD, GHD was suspected because of a poor catch-up growth despite a good adherence to the GFD. In two other cases, firstly diagnosed with GHD, gastrointestinal symptoms revealed the diagnosis of CD. Normalization of height velocity was achieved by GH treatment in all cases. No statistical significant difference between the two groups of patients was found as regard laboratory and histological features of CD. It is to note that 2 out of 4 patients with concomitant CD and GHD had thyroiditis compared to 6% of patients with isolated CD (P=0.004).
CONCLUSION: We found a high prevalence of associated CD and GHD. CD patients with poor catch- up growth despite a good adherence to the GFD should be carefully investigated for endocrinological disorders.

language: English


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