Changing Scenario in Aetiological Profile of Short Stature in India-Growing Importance of Celiac Disease: A Study from Tertiary Care Centre

Abstract

To compare the etiological profile of short stature at a tertiary care hospital of North India over a decade from 1995-2007. Children attending the Post Graduate Institute of Medical Education and Research and also fulfilling the criteria for short stature over the two time periods of 1995-96 and 2005-07 were analyzed retrospectively for causes of short stature. The age group of children ranged from 10 to 15 years. Appropriate screening and definitive tests were performed to establish the etiology of short stature. In the year 1995-1996, 190 children with short stature were diagnosed. The common causes of short stature were primary hypothyroidism in 35(18.4%) followed by pituitary disorders in 29(15.2%) and nutritional disorders in 33(17.4%) while in year 2005-2007, 256 children were diagnosed with short stature. The etiology of short stature in these children were pituitary disorders in 51(19.2%) followed by celiac disease in 35(13.7%) and hypothyroidism in 35(13.7%) cases. In majority of celiac disease patients growth retardation was the presenting manifestation rather than gastrointestinal symptoms. Etiology of short stature significantly changed over a decade probably due to high index of suspicion and wide and better availability of screening tests for celiac disease. We propose all growth retarded children should be screened for celiac disease irrespective of gastrointestinal symptoms as well as periodic review of etiology of short stature.