title: Coeliac disease in patients with short stature: A tertiary care centre experience.
abstract: BACKGROUND
  We aimed to determine the prevalence of coeliac disease among children with short stature at a tertiary care centre and to define the predictors for coeliac disease, if any, in them.
  
  
  METHODS
  In this retrospective study, we reviewed the case records of children and adolescents with growth retardation attending the Paediatric Endocrinology Clinic from January 2008 to June 2011. All patients underwent the multi-tier stratified diagnostic protocol for complete evaluation of short stature. Coeliac disease was screened using IgA-anti-tissue transglutaminase antibody. The diagnosis of coeliac disease was made on the basis of the modified European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) criteria.
  
  
  RESULTS
  Of 432 patients (238 boys) who presented with short stature, 72 (16.7%) had physiological, while 360 (83.3%) had pathological causes. Endocrine causes were growth hormone deficiency (86 patients, 19.9%), hypopituitarism (31, 7.2%), hypothyroidism (22, 5.1%) and others (7, 1.6%). The systemic causes were: coeliac disease (47, 10.9%), haematological diseases (14, 3.2%), renal diseases (11, 2.5%) and others (24, 5.6%). Chronic diarrhoea (OR 15.7, 95% CI 7.8-31.5) and anaemia (OR 4.9, 95% CI 1.9-12.7]) were significant predictors for coeliac disease in patients with short stature. There was a definite response to gluten-free diet in them and the mean (SD) growth velocity measured over at least 6 months of gluten-free diet was 8.1 (3.0) cm/year.
  
  
  CONCLUSIONS
  Nearly 11% of patients presenting with short stature have coeliac disease. In these patients chronic diarrhoea and anaemia were significant predictors of coeliac disease.
authors.affiliation: Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
authors.forename: Prashant
authors.initials: P
authors.lastname: Singh
authors.affiliation: Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
authors.forename: Piyush Kumar
authors.initials: PK
authors.lastname: Sharma
authors.affiliation: Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Agnihotri
authors.affiliation: Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
authors.forename: Viveka P
authors.initials: VP
authors.lastname: Jyotsna
authors.affiliation: Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
authors.forename: Prasenjit
authors.initials: P
authors.lastname: Das
authors.affiliation: Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
authors.forename: Siddhartha Datta
authors.initials: SD
authors.lastname: Gupta
authors.affiliation: Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
authors.forename: Govind K
authors.initials: GK
authors.lastname: Makharia
authors.affiliation: Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Khadgawat
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D001827:Body Height; D001835:Body Weight; D002446:Celiac Disease / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D002657:Child Development; D005260:Female; D019204:GTP-Binding Proteins / Q000276:immunology; D006130:Growth Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D011379:Prognosis; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D012189:Retrospective Studies; D012307:Risk Factors; D063128:Tertiary Health Care / Q000706:statistics & numerical data; D011503:Transglutaminases / Q000276:immunology
chemical_list: D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins