Background: Coeliac disease (CD) can be associated with impaired growth in children after a prolonged period of Gluten-free diet (GFD). A small percentage of CD patients does not show catch-up growth during GFD because of GH secretion deficiency (GHD) that could be associated with antipituitary autoantibodies (APA).
Objective and hypotheses: This study aims to evaluate the efficacy of recombinant human GH (rhGH) therapy on final adult height in children with CD and GHD associated with APA.
Method: We evaluated six CD patients with persistent growth impairment after at least 1 year from the GFD initiation due to GHD. APA and/or antihypothalamus autoantibodies resulted positive at high titers in four out of six CD-GHD patients. They all started rhGH therapy at the recommended weekly dose of 0.233±0.007 mg/kg s.c. for a mean period of 3.21±1.88 years.
Results: Patients showed a significant gain of height SDS from the onset of rhGH therapy to the stop time (−2.09±0.35 vs −1.00±0.43, respectively; P=0.0277) and the final adult height SDS, evaluated after 1 year from the rhGH interruption, was within the target height (−0.81±0.69 vs −0.57±0.61, respectively; P=0.248). Results did not changed analysing data according to APA and/or AHA status (positive vs negative): final adult height was consistent with the target height.
Conclusion: In patients with CD and GHD the association of GFD and rhGH treatment seems to allow an adequate catch-up growth and the achievement of height within target height and presence of LYH seems not to influence the efficacy of the treatment.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology