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  • Title: Growth hormone deficiency and coeliac disease: an unusual association?
    Author: Bozzola M, Giovenale D, Bozzola E, Meazza C, Martinetti M, Tinelli C, Corazza GR.
    Journal: Clin Endocrinol (Oxf); 2005 Mar; 62(3):372-5. PubMed ID: 15730422.
    Abstract:
    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.
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