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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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Just watch out. I just went to the expo in Schaumburg, IL, and ended up getting glutened. I realized afterward that I ate all these samples thinking they were gluten free, and they weren't. One company was advertising some sugar, and had made some cake, but then I realized.... How do I know if this contains any other ingredients that might have gluten? Did they make it with a blender or utensils that had gluten contamination? Makes me realize the only safe things would be packaged giveaways with gluten free labeling. My fault for not thinking things through. It was just too exciting thinking i could try it all and enjoy without worry.

No fasting required for a celiac blood test unless they were checking your blood glucose levels during the same blood draw.

I wish! I got the flu this winter as well as a couple of colds. I do have 3 lids, the youngest in preschool, so there's always a lot of germs around. Lol

Hey again ? It's a start, but I so wish they'd done the whole panel. Some of us, myself included, test negative to the TTG-IgA. I was positive on the DGP only. I wonder if your insurance will only cover those 2? Regardless, get them done as soon as you can! Do you have a walk in lab where you live? If so, go tomorrow. Then you'll be a step closer to getting answers. Good luck and keep us posted!

I totally agree...this board is awesome! The people on here have been there for me through everything and it has helped so much! I don't think antihistamines would affect the test at all. I take an antihistamine daily as well for horrendous allergies.