身材矮小儿童中生长激素缺乏症和乳糜泻的患病率。
The prevalence of growth hormone deficiency and celiac disease in short children.
作者信息
Giovenale Diletta, Meazza Cristina, Cardinale Giuliana M, Sposito Maddalena, Mastrangelo Costanzo, Messini Beatrice, Citro Giuseppe, Delvecchio Maurizio, Di Maio Salvatore, Bozzola Mauro
机构信息
Dipartimento di Scienze Pediatriche, Università degli Studi di Pavia, IRCCS Policlinico San Matteo, Pavia, Italia.
出版信息
Clin Med Res. 2006 Sep;4(3):180-3. doi: 10.3121/cmr.4.3.180.
OBJECTIVES
To assess the occurrence of growth hormone deficiency (GHD) in patients with celiac disease (CD) referred for short stature.
DESIGN
A retrospective, multi-center study. A total of 7066 children with short stature were referred to a number of centers for second-line evaluation over a 5-year period. All patients were screened for CD by antiendomysial antibodies (EMA) and antitissue transglutaminase IgA. Those with positive sera underwent intestinal biopsy. The EMA-negative patients and the EMA-positive ones who did not grow after 1 year of gluten-free diet underwent endocrinological investigation.
RESULTS
Among the 7066 short children (age 2-14 years) evaluated, 650 (9.2%) had GHD and 44 (0.63%) had CD. An association of both CD and GHD was found in 16 short children (0.23%); these children did not grow after 1 year of gluten-free diet and therefore GH treatment was started.
CONCLUSIONS
GH secretion should be evaluated in celiac patients showing no catch-up growth after an appropriate period on a gluten-free diet in spite of reversion to seronegativity for EMA.
目的
评估因身材矮小而转诊的乳糜泻（CD）患者中生长激素缺乏症（GHD）的发生率。
设计
一项回顾性多中心研究。在5年期间，共有7066名身材矮小的儿童被转诊至多个中心进行二线评估。所有患者均通过抗肌内膜抗体（EMA）和抗组织转谷氨酰胺酶IgA筛查CD。血清学阳性的患者接受肠道活检。EMA阴性的患者以及在无麸质饮食1年后仍未生长的EMA阳性患者接受内分泌学检查。
结果
在评估的7066名矮小儿童（年龄2至14岁）中，650名（9.2%）患有GHD，44名（0.63%）患有CD。在16名矮小儿童（0.23%）中发现CD和GHD并存；这些儿童在无麸质饮食1年后仍未生长，因此开始生长激素治疗。
结论
对于尽管EMA血清学转为阴性，但在适当时间的无麸质饮食后仍未出现追赶生长的乳糜泻患者，应评估其生长激素分泌情况。
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