[Celiac disease as a cause of short stature in children].

BACKGROUND

Growth retardation may be the only clinical manifestation of undiagnosed chronic intestinal disease. Therefore we have to consider also this etiology in the differential diagnosis of classical causes of short stature in children with typical clinical and laboratory findings.

METHODS AND RESULTS

Among 168 patients aged 5.5-17.2 years up to June 1, 1993 on the records of the Paediatric Clinic in Olomouc on account of marked growth retardation (< or = 2 SDS) associated with retarded bone age were eight children where based on screening for antigliadin antibodies the suspicion of coeliac disease was expressed. By introduction of a gluten-free diet the growth rate improved markedly in almost all patients already during the first six months. After a one-year follow-up it increased to 9.0 +/- 1.1 cm from 3.9 +/- 1.3 cm, and concurrently a corresponding progression of ossification occurred. An exception was only a 14-year-old girl who did not comply and did not adhere to the diet.

CONCLUSION

In the early diagnosis of oligosymptomatic coeliac disease with a low growth rate as the dominant symptom a key role is played by assessment of antibodies against gliadin. If the results are positive, enterobiopsy is indicated which alone can confirm the diagnosis. Dietetic provisions (a gluten-free diet) improve the growth rate and bone maturation.