Coeliac disease in patients with short stature: A tertiary care centre experience.
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Date
2015-07
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Abstract
Background. We aimed to determine the prevalence of
coeliac disease among children with short stature at a tertiary
care centre and to define the predictors for coeliac disease, if
any, in them.
Methods. In this retrospective study, we reviewed the case
records of children and adolescents with growth retardation
attending the Paediatric Endocrinology Clinic from January
2008 to June 2011. All patients underwent the multi-tier
stratified diagnostic protocol for complete evaluation of short
stature. Coeliac disease was screened using IgA-anti-tissue
transglutaminase antibody. The diagnosis of coeliac disease
was made on the basis of the modified European Society of
Paediatric Gastroenterology, Hepatology and Nutrition
(ESPGHAN) criteria.
Results. Of 432 patients (238 boys) who presented with
short stature, 72 (16.7%) had physiological, while 360
(83.3%) had pathological causes. Endocrine causes were
growth hormone deficiency (86 patients, 19.9%),
hypopituitarism (31, 7.2%), hypothyroidism (22, 5.1%)
and others (7, 1.6%). The systemic causes were: coeliac
disease (47, 10.9%), haematological diseases (14, 3.2%),
renal diseases (11, 2.5%) and others (24, 5.6%). Chronic
diarrhoea (OR 15.7, 95% CI 7.8–31.5) and anaemia (OR
4.9, 95% CI 1.9–12.7]) were significant predictors for
coeliac disease in patients with short stature. There was a
definite response to gluten-free diet in them and the mean
(SD) growth velocity measured over at least 6 months of
gluten-free diet was 8.1 (3.0) cm/year.
Conclusion. Nearly 11% of patients presenting with short
stature have coeliac disease. In these patients chronic diarrhoea
and anaemia were significant predictors of coeliac disease.
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Singh Prashant, Sharma Piyush Kumar, Agnihotri Abhishek, Jyotsna Viveka P., Das Prasenjit, Gupta Siddhartha Datta, Makharia Govind K., Khadgawat Rajesh. Coeliac disease in patients with short stature: A tertiary care centre experience. National Medical Journal of India. 2015 Jul-Aug; 28(4): 176-180.