My toddler celiac has fractured her leg for the second time, so I have started doing investigation on the correlation between fractures and celiac disease. (Have I mentioned that I am a scientist myself? Sure, I study the weather, but the need to research is in my blood.) Unfortunately, it looks like there is a correlation. In the 2007 article, Celiac Disease and Risk of Associated Bone Fractures, it says that children (and adults) with Celiac disease are significantly more likely to fracture bones for up to 20 years after diagnosis. It looks like these results were again confirmed in 2011. I am not entirely sure how to treat this since she is already getting a liquid multivitamin and gets plenty of calcium. Any tips?
By Anita Wilkinson
26 March 2010
Am J Gastroenterol 2010; 105: 691-696
MedWire News: Poor growth in children with celiac disease (CD) could relate to the pituitary gland, Italian study findings suggest.
Children newly diagnosed with CD were more likely to be positive for anti-pituitary antibodies (APA) than those without the disease.
Testing positive for APA correlated with restricted height, and the researchers speculate this is mediated by a reduction in insulin growth factor (IGF)-1.
The possible autoimmune involvement of the pituitary gland in patients with CD has only been demonstrated in a few patients on a gluten-free diet, say Maurizio Delvecchio, from IRCCS Casa Sollievo della Sofferenza in San Giovanni Rotondo, and colleagues.
They recruited 119 patients aged up to 16 years who had CD and attended an inpatient clinic, and compared them with 98 gender- and age-matched control individuals.
APA, all of class IgG, were detected in 50 (42.0%) patients, 15 with high titer defined as detectable at a dilution of at least one in 16, and 35 with low titer detectable at less than one in eight dilution.
This compared with detectable low titer APA in just two controls, the authors report in the American Journal of Gastroenterology.
IGF-1 levels were significantly higher in patients negative for APA than in those with either a low or high titer. APA patients with a high titer were also shorter than in those testing APA negative.
Height was positively correlated with IGF-1 and negatively correlated with the age of individuals. IGF-1 was positively correlated with body mass index.
Alessio Fasano and Debra Counts, from the University of Maryland Medical Center in Baltimore, USA, comment in an editorial accompanying the study.
They write: “Given the strong association of CD with other autoimmune disease, including autoimmune endocrine disease, these authors’ findings show one possible etiology for the poor growth seen in children with CD.”
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010