Mechanisms of abnormal puberty in coeliac disease.
Coeliac disease (CD) is one of the most frequent chronic diseases in childhood. The clinical spectrum has changed; in addition to the classical gastrointestinal form, other clinical manifestations have been described, such as hypogonadism and the consequent delay in onset of puberty. Recent studies reported not only a significantly retarded menarche in untreated CD girls as compared with girls following a gluten-free diet, but also in treated CD a negative effect on pregnancy, resulting in lower birth weight and shorter duration of pregnancy. In boys, there is a reduced serum level of dihydrotestosterone and an increased serum level of luteinizing hormone, an abnormality pattern suggesting androgen resistance. The pathogenesis of CD-related reproductive disorders is still unclear. Some hypotheses may be tried; for example, in CD there is a high level of autoantibodies directed against self-antigens, so there could be antibodies directed against hormones or organs critical for pubertal development. Moreover, in CD there could be a selective malabsorption of micronutrients essential for the metabolism of carrier or receptor proteins for sex hormones.
Bona
Gianni
G
Pediatric Unit, Department of Medical Sciences, University of Piemonte Orientale A. Avogadro, Novara, Italy. gianni.bona@maggioreosp.novara.it
Marinello
Daniela
D
Oderda
Giuseppina
G
D001323:Autoantibodies / Q000378:metabolism; D002446:Celiac Disease / Q000150:complications* / Q000178:diet therapy / Q000503:physiopathology; D002648:Child; D005260:Female; D005298:Fertility; D005983:Glutens; D006801:Humans; D007006:Hypogonadism / Q000378:metabolism; D008297:Male; D011627:Puberty / Q000502:physiology*; D011628:Puberty, Delayed / Q000503:physiopathology
D001323:Autoantibodies; D005983:Glutens