Coeliac disease (CD) has a negative influence on growth in children; however, the institution of gluten free diet (GFD) significantly improves height and weight velocity, so that height shows a full catch-up within about 2 years, even if it does not always happen. The absence of catch-up growth has been related to an impaired growth hormone (GH) secretion due to hypothalamic dysfunction. In CD patients some autoimmune endocrine alterations have been demonstrated and recently the occurrence of autoimmune hypophysitis has been suggested. Aim of this study is to investigate whether a poor auxological response to GFD with persistence of GH deficiency in a group of CD patients could be due to a coexistence of an autoimmune hypophysitis. Seven out of 130 CD patients were selected on the basis of poor catch-up growth (height < - 2 SDS) after 2 years of good adherence to a GFD as demonstrated by the negativity of the specific immune markers. All patients were submitted to blood sample collection to study the GH secretion after 2 different stimuli (arginine, clonidine, or L-DOPA) and to search for auto-antibodies against hypothalamus and hypophysis by immunofluorescence method. A decreased GH-stimulated secretion (<10 ng/ml) was demonstrated in 5 cases out of 7 CD children with poor catch-up growth and 4 of them resulted strongly positive for auto-antibodies against hypothalamus and hypophysis. Cerebral and hypophyseal NMR was normal in all children.Our study confirms the existence in some CD patients of a persistent GH secretion impairment causing a poor statural catch-up growth also after GFD. Moreover, our data strongly suggest that this impairment can have an autoimmune origin and that in patients with CD the occurrence of this autoimmune disturbance is more frequent than that so far thought. This has to lead to a more accurate evaluation of endocrine autoimmunity in these patients.
|Data di pubblicazione:||2005|
|Titolo:||Lack of growth recovery and persistence of growth hormone deficiency in patients with coeliac disease after a prolonged time-span of gluten free diet can be caused by an autoimmune hypophysitis|
|Autore/i:||L. Iughetti; A. De Bellis; B. Predieri; S. Madeo; A. Stendardo; A. Bizzarro; A. Bellastella; F. Balli; S. Bernasconi|
|Titolo del libro:||Abstract ESPE/LWPES 7th Meeting|
|Citazione:||Lack of growth recovery and persistence of growth hormone deficiency in patients with coeliac disease after a prolonged time-span of gluten free diet can be caused by an autoimmune hypophysitis / L. Iughetti; A. De Bellis; B. Predieri; S. Madeo; A. Stendardo; A. Bizzarro; A. Bellastella; F. Balli; S. Bernasconi. - In: HORMONE RESEARCH. - ISSN 0301-0163. - STAMPA. - 64 (s1)(2005), pp. 248-248. ((Intervento presentato al convegno ESPE/LWPES 7th Meeting tenutosi a Lyon nel 21-24 settembre 2005.|
|Tipologia||Abstract in Rivista|
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