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身材矮小儿童的乳糜泻

Celiac disease in children with short stature.

作者信息

Dehghani Seyed Mohsen, Asadi-Pooya Ali Akbar

机构信息

Department of Pediatrics and Gestroentero-hepatology Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Indian J Pediatr. 2008 Feb;75(2):131-3. doi: 10.1007/s12098-008-0019-4.

Abstract

OBJECTIVE

The aim of the present study was to determine the prevalence of celiac disease in children with short stature.

METHODS

In all children with short stature (height more than 2 SD below the mean for age and sex) and normal physical examination, attending Motahary pediatric clinic in Shiraz, Iran, from 2003 till 2005, work-ups were made to find a cause for their short stature and of course their serum was assayed for IgG anti-tissue transglutaminase (TTG) antibody by ELISA test, as a marker for CD.

RESULTS

There were 26 girls and 46 boys with mean age of 9.8 years. Routine work-up showed microcytic hypochromic anemia in four children (5.6%) and giardiasis in five (6.9%). GH stimulation test revealed GH deficiency in five children (6.9%). Elevated IgG anti-TTG antibody level was detected in two children (2.8%). Duodenal biopsies of these children were in favor of celiac disease.

CONCLUSION

Although, the prevalence of CD in this study was not significantly different (P value = 0.14) from the prevalence rate in healthy blood donors in Iran, the findings emphasize the fact that CD must be considered in a child with short stature, especially if the height is more than 3 SD below the mean for sex and age, even in the absence of gastrointestinal symptoms. In conclusion, the measurement of anti-TTG antibody should be included in the diagnostic evaluation of children with short stature.

摘要

目的

本研究旨在确定身材矮小儿童中乳糜泻的患病率。

方法

2003年至2005年期间,在伊朗设拉子的Motahary儿科诊所就诊的所有身材矮小(身高低于年龄和性别的均值2个标准差以上)且体格检查正常的儿童,均进行了检查以寻找其身材矮小的原因,当然通过酶联免疫吸附测定法检测他们血清中的抗组织转谷氨酰胺酶(TTG)IgG抗体,作为乳糜泻的标志物。

结果

有26名女孩和46名男孩,平均年龄9.8岁。常规检查显示4名儿童(5.6%)有小细胞低色素性贫血,5名儿童(6.9%)有贾第虫病。生长激素刺激试验显示5名儿童(6.9%)生长激素缺乏。2名儿童(2.8%)检测到抗TTG IgG抗体水平升高。这些儿童的十二指肠活检结果支持乳糜泻。

结论

尽管本研究中乳糜泻的患病率与伊朗健康献血者的患病率相比无显著差异(P值 = 0.14),但研究结果强调,对于身材矮小的儿童,尤其是身高低于性别和年龄均值3个标准差以上的儿童,即使没有胃肠道症状,也必须考虑乳糜泻。总之,抗TTG抗体的检测应纳入身材矮小儿童的诊断评估中。

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