Anti-pituitary antibodies in children with newly diagnosed celiac disease: a novel finding contributing to linear-growth impairment.

Objective The possible autoimmune involvement of the pituitary gland in patients with celiac disease (CD) was suggested, but demonstrated only in few patients on gluten free diet. We aimed to assess prevalence and clinical meaning of antipituitary antibodies (APA) in children and adolescents with newly diagnosed CD.Design Cross-sectional.Setting Inpatient Clinic of University Hospital.Patients 119 celiac patients (0.9 – 15.8 years old).Intervention and main outcome measures Auxological data, height, weight and body mass index (BMI), were recorded, insulin-like growth factor-1 (IGF-1) and APA assayed. APA were assayed also in 98 sex- and age-matched controls. Results APA were detected in 50 patients (42.0%), 15 of them with high titre (30%) and 35 with low titre (70%), and in 2 control subjects at low titre (2%) (p < 0.001). IGF-1 was higher in patients with negative than with low titre (p = 0.02) or high titre APA (p = 0.03). Height was more reduced in hig titre APA patients than in negative (p < 0.01). Height was positively correlated with IGF-1 (p < 0.01) and negatively with chronological age (p = 0.001). IGF-1 was positively correlated with BMI (p < 0.001). The regression analysis showed the rank order 1 for chronological age and 2 for IGF-1 for height prediction.Conclusions Our paper shows a remarkable prevalence of positive APA in newly diagnosed CD patients. High APA titres are associated with height impairment, likely mediated by a reduction of IGF-1 suggesting that autoimmune pituitary process could induce a linear growth impairment.