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Linear-growth Impairment and Anti-pituitary Antibodies in Children with Newly Diagnosed Celiac Disease

Celiac.com 12/16/2009 - Research has suggested potential autoimmune involvement of the pituitary gland in patients with celiac disease, but such activity has only been shown in only a few patients on gluten-free diet.

A team of researchers recently set out to assess the prevalence and clinical meaning of anti-pituitary antibodies (APA) in children and adolescents with the newly diagnosed celiac disease. The research team was made up of M. Delvecchio, A. De Bellis, R. Francavilla, V. Rutigliano, B. Predieri, F. Indrio, D. De Venuto, A. A. Sinisi, A. Bizzarro, A. Bellastella, L. Iughetti, and L. Cavallo.

They are affiliated with the Unità Operativa Complessa di Pediatria, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy.

The team set out to assess the prevalence and clinical meaning of anti-pituitary antibodies (APA) in children and adolescents with the newly diagnosed celiac disease.

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For their cross-sectional study, the team recruited atonal of 119 patients with celiac disease from the inpatient clinic of University Hospital.

Test subjects ranged from 0.9 to 15.8 years in age. Clinicians recorded their height, weight, and body mass index (BMI), and assayed their insulin-like growth factor-1 (IGF-1) and APA.

Researchers determined APA in 98 sex- and age-matched control subjects. They found APA in 50 of those subjects (42.0%), 15 of whom showed high titer (30%), 35 showed low titer (70%), and 2 control subjects showed low titer (2%) (P<0.001).

More patients with negative than with low titer (P=0.02) or high titer APA (P=0.03) showed higher IGF-1. High-titer APA patients showed more reduced height than did negative ones (P<0.01). Researchers positively correlated height with IGF-1 (P<0.01) and negatively with chronological age (P=0.001). They positively correlated IGF-1 with BMI (P<0.001). For height prediction the regression analysis showed the rank order 1 for chronological age and 2 for IGF-1.

This results of this study demonstrate a substantial prevalence of positive APA in newly diagnosed celiac disease patients. High APA titers are associated with reduced height impairment, likely mediated by a reduction of IGF-1, thus indicating that autoimmune pituitary process may induce a linear-growth impairment.

Source:
Am J Gastroenterol advance online publication, 10 November 2009; doi:10.1038/ajg.2009.642.

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