Celiac Disease and GH Deficiency in Children: A Case Report

Abstract

Growth is a complex and multifactorial process influenced by a combination of genetic, environmental, and hormonal factors. The regulation of growth involves a delicate balance of these factors, with hormones, such as growth hormone (GH), playing a pivotal role in the development of linear growth. Growth disorders, such as stunted growth, are common reasons for consultation in pediatric practices. However, diagnosing the cause of stunted growth can be a challenging task, as there are numerous potential contributing factors. These factors are often intertwined, with patients frequently presenting with two or more abnormalities simultaneously, such as growth hormone deficiency (GHD) and celiac disease. This overlapping of conditions can complicate diagnosis, as the symptoms of one condition may mask those of another, leading to a delay in identifying the true underlying cause. In our observation, we report two cases of patients who presented with growth disorders, each demonstrating how one condition can obscure another. The first patient was initially diagnosed with celiac disease, and while a gluten-free diet was implemented, there was little improvement in growth. Further investigations revealed an additional diagnosis of growth hormone deficiency, highlighting the importance of considering multiple diagnoses in cases of stunted growth. The second patient was first diagnosed with growth hormone deficiency, but after further evaluation, a diagnosis of celiac disease was made, which helped explain the persistence of the growth issues. In conclusion, stunted growth can result from various factors, and the presence of one disease can mask another. Thus, it is crucial to conduct thorough investigations and reconsider initial diagnoses to ensure that all potential causes are explored and appropriately addressed.