Celiac disease in children with short stature: a hospital based study

ABSTRACT

To identify the prevalence of celiac disease [CD] among children with short stature. Celiac disease [CD] is genetically determined gluten-sensitive enteropathy resulting in nutrient malabsorption, with an increasing incidence world-wide. A retrospective, hospital based study is conducted at a pediatric endocrine clinic, King Khalid University Hospital, Riyadh. During the period between January 1990 and December 2009, the medical records of patients evaluated for short stature were reviewed. After a proper detailed history and physical examination, growth analysis, followed by radiological [bone age], and laboratory screening [CBC, and thyroid function] were performed. Celiac serological screening and chromosomal analysis were performed when appropriate, followed by small intestinal biopsy if indicated. Growth hormone stimulation test was performed in suspected patients, followed by magnetic resonance imaging [MRI] in positive cases. Hundred and ten patients were evaluated for short stature over the period under review. Their age ranged from 2.6 to 14 years. The male to female ratio was 1.31. The commonest cause was genetic and found in approximately 51.8%, while in the other 48.2%, variable endocrine and non-endocrine causes were noted. Of the non-genetic short stature, 5 [10%] patients were found to have celiac disease, i.e. 4.5% of short children. The prevalence of celiac disease is not rare in this study, therefore, celiac disease must be considered as an important cause of short stature. As, it could be a silent disease, it is recommended that a serological screening be done first to all patients before performing dynamic growth hormone testing in the evaluation of short stature