43 SHORT STATURE AND CELIAC DISEASE: CAN THE SIMPLE DETECTION OF THE ANTIBODIES TO GLIADIN RESOLVE THIS RELATIONSHIP?

Abstract

107 nonselected children (77 n. and 30 f.) with short stature and absence of gastrointestinal tract symptoms were examined. In addition to the normal tests for the pathogenetic definition of short stature, in all patients a duodenal biopsy was performed and antibodies to gliadin were detected (immunofluorescence (IFL-AGA) and a micro-ELISA method (ELISA-AGA)) We found 8 children (7.5%) with total villous atrophy probably due to celiac disease, 7 children (6.5%) with partial villous atrophy, and 4 children (3.7%) with complete GH deficiency. IFL-AGA were found in 17 (15.9%) cases: in all the 8 (100%) children with total villous atrophy, in 3 (42.8%) children with partial villous atrophy, and in 6 (6.5%) short normal children. ELISA-AGA were detected in: 7 (87.5%) of the 8 children with total villous atrophy, in 4 (57.1%) patients with partial villous atrophy, in 1 (25%) patient with complete GH deficiency, and in 9 (9.8%) short normal children. These two tests were discordant in: 1 case of total villous atrophy, 1 case of partial villous atrophy, 1 case of complete GH deficiency and in 3 cases of short normal children. IFL-AGA therefore, seem to be able to detect all the cases with total villous atrophy (probable celiac disease), while its significance in the cases with partial villous atrophy is not yet clear. The same test gives an acceptable percentage (6.5%) of certainly false positivity. ELISA-AGA appear to be less specific. In conclusion, the relationship between short stature and celiac disease seems to be clearly resolvable by means of a simple detection of the IFL-AGA.