Auxo-Endocrinological Approach to Celiac Children

Abstract

Celiac disease is a permanent genetically determined intolerance to gluten that generally presents with gastrointestinal symptoms in young children and extraintestinal manifestations (endocrinological, dermatological, neurological, etc.) later. Furthermore, many studies demonstrate the close association between celiac and endocrine diseases, including growth and pubertal disorders, type I diabetes mellitus and autoimmune thyroid diseases, probably due to the presence of a common genetic predisposition. Follow-up for celiac children after the start of gluten-free diet is mandatory to avoid complications such as growth hormone deficiency. The present review deals with the problem of the diagnosis of endocrine-associated diseases in celiac children and gives suggestions for correct management and follow-up of these patients.

Keywords: celiac disease; children; endocrine diseases; linear growth.

Figure 1

Example of patients with height below the 3rd percentile (A), with height, initially above the 50th percentile, that decreases to a lower percentile (B) and with height within the 3rd percentile that does not decrease to a lower percentile (C).

Figure 1

Example of patients with height below the 3rd percentile (A), with height, initially above the 50th percentile, that decreases to a lower percentile (B) and with height within the 3rd percentile that does not decrease to a lower percentile (C).

Figure 2

Example of a deceleration of growth rate in a CD child and catch-up growth after the introduction of a GFD.

Figure 3

Height Standard Deviation Score (SDS) in CD-GHD patients at CD diagnosis, at GHD diagnosis, after 1 year of GH replacement therapy and at final height. Results are expressed as mean ± SEM (Standard Error of Mean) [9].