[Procollagen III propeptide. Values in the course of pediatric celiac disease].

OBJECTIVES

An explanation for an incomplete catch-up growth in children with coeliac disease has not yet been found. The marker of growth procollagen-III-propeptide could possible provide a better understanding of the actual regulation of growth in the situation.

METHODS

The investigation was made in children with established coeliac disease (n = 30). A commercial radioimmunoassay was used for the measurement of PC-III-P.

RESULTS

A close relationship (r = 0.75; P < 0.0001) was found between height velocity and PC-III-P in serum of coeliac children. There was also a good correlation (r = 0.54; P < 0.001; n = 72) with serum levels of alcaline phosphatase. Only weak correlations were found to insulin-like growth factor I (r = 0.33; P < 0.05; n = 62), to urinary calcium (r = 0.27; P < 0.05; n = 62), and to the maturation of bones (r = 0.25; P < 0.05; n = 54). In accordance with the good correlation between height velocity and PC-III-P normal results were found in normal growing children with coeliac disease. Reduced serum levels of PC-III-P were found in coeliac children who failed to show a complete catch-up growth while on a gluten-free diet.

CONCLUSIONS

Gluen challenge, as required for the confirmation of the diagnosis, led to a significant further decrease of the values of PC-III-P. Parallel investigations for IgA endomysium antibodies in serum suggest that besides dietary errors additional factors may impede growth, or in other words that disorders of growth regulation persist in some patients with coeliac disease even under treatment. This assumption will have to be tested by further investigations.