Abstract
The aim of the present study was to determine the prevalence of celiac disease in children of short stature and to assess whether some of the routine laboratory examinations performed to determine the cause of short stature could suggest the presence of celiac disease. A total of 106 children of short stature and no gastrointestinal symptoms were studied. An extensive endocrine work-up had been negative for all of them and an additional investigation was performed by measuring the concentration of antiendomysial antibody. Patients who were positive for antiendomysial antibody (> or =1:10) or who exhibited IgA deficiency (less than 5 mg/dl) were referred for an endoscopic intestinal biopsy. We detected a pathological titer of antiendomysial IgA in six of these patients. Five of them showed histological abnormalities compatible with celiac disease and one had normal histology and was considered to have potential celiac disease. The prevalence of celiac disease in the population studied was 4.7% (with another 0.9% of the subjects being considered to have potential celiac disease). The children with celiac disease did not differ in any of the parameters tested when compared to those without celiac disease, though they showed an improvement in growth velocity after treatment with a gluten-free diet. We conclude that it is important to test all children with short stature for celiac disease by measuring antiendomysial IgA.
Highlights
Celiac disease is characterized by malabsorption resulting from inflammatory injury of the mucosa of the small intestine after ingestion of wheat gluten or related rye and barley proteins
Celiac disease was considered uncommon in Brazil and no studies were conducted to assess its prevalence; the availability of new accurate serologic tests has led to the realization that celiac disease could be relatively common
The purpose of the present study was to determine the prevalence of celiac disease among Brazilian children with short stature who have no gastrointestinal symptoms, and to assess whether some of the routine laboratory examinations performed during investigation of the cause of short stature could suggest the diagnosis of celiac disease
Summary
Celiac disease is characterized by malabsorption resulting from inflammatory injury of the mucosa of the small intestine after ingestion of wheat gluten or related rye and barley proteins. The highest reported prevalence has been observed among western Europeans and in countries to which Europeans emigrated, notably North America and Australia. It is rare among people of purely African-Caribbean, Chinese, or Japanese background [1]. Braz J Med Biol Res 37(1) 2004 parently healthy blood donors, while another study [3] carried out on patients diagnosed as having celiac disease described a spectrum of presentation similar to that observed in other developing countries. Celiac disease has a wide spectrum of gastrointestinal and extraintestinal manifestations, with many patients showing atypical symptoms or none at all. Atypical disease is usually seen in older children or adolescents, who often have no overt features of malabsorption. In addition to recurrent abdominal pain, aphthous stomatitis, arthralgia, defects in dental enamel, short stature, and delayed puberty, affected children may show behavioral disturbances such as depression and irritability, and may perform poorly in school [4]
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