ESPE Abstracts (2019) 92 P2-193

Linear Growth of Children with Celiac Disease (CD) after the First Two Years on a Gluten-Free Diet (GFD); A Controlled Study

ASHRAF TAWFIK SOLIMAN, Muhannad Laham, Celine Jour, Maya Itani, Mona Shaat, Fatima Souikey, Noora Al-Naimi, Athba Al-Safi, Anwar Qudaisat, Zohair Alarabi, Ayman Hassan, Eyad Quraan, sohair Elsiddig


Hamad General Hospital, Doha, Qatar


We evaluated the effect of GFD on the growth of children with the classical form of CD on long-term GFD (> 2 years).

Methods: We studied growth parameters (weight gain/day, BMI and BMISDS, HtSDS) and lab data for 30 prepubertal children aged 8.5 years +/−3 years with CD, who were on GFD since the age of 3.4 years +/−2.6 years (> 2 years on GFD) for duration of 1 year. The anthropometric data of 30 randomly selected normal, age and sex-matched, children were used as a control.

Results: The weight gain per day was average or above average for age and sex in 27 children and below average in 3. Two out of those 3 children had slow linear growth (decreased HtSDS by -0.56 and -0.1 over one year). BMISDS was normal in 26 /30 patients (> -1.5). BMI SD changed from −0.36 +/−1.1 to −0.33 +/−1.1 during the year of treatment. BMISDS decreased in 9 children during the follow up period that can be explained by their fast-linear growth (increased HtSDS) in seven of them. The HTSDS was < −2 in four out of the 30 children at the beginning of F/U and in 2 children after a year of F/U (catch up in two), HTSDS remained normal or increased in 28/30 children during the year of treatment (−0.38 +/−1.2 to −0.22 +/−1.1), a positive trend = 0.15 +/−0.4 SD. Only one patient crossed down 1 major height centiles during the year of follow up, with low weight gain/day and decreased BMISDS that can be explained by incompliance with the GFD. HtSDS and BMISDS increased significantly in the CD group versus controls during the year of follow-up. All patients had normal serum albumin, liver enzyme and hemoglobin levels. 33.3 % of patients had low Ferritin level and 33.3% Had Vitamin D deficiency.

Discussion: Most of our children with CD grew normally both in height and weight on GFD. Catch-up growth still occurs in some of them after 2 years of being on GFD. All had normal Hb and albumin level. Those with low BMISDS and/or HtSDS need further management including reinforcement on following strictly the GFD and investigating other factors that might affect growth pattern

Conclusion: Catchup growth continues in some children with CD on GFD even after 2 years of being on GFD. Measuring weight gain /day is a sensitive indicator for monitoring growth in these children.