Celiac disease is a chronic inflammatory autoimmune disorder often associated with other endocrine autoimmune diseases, such as type I diabetes mellitus, Addisons disease and Hashimotos thyroiditis. In these patients, LH, FSH and GH secretion has been poorly investigated. Aim of this study is to evaluate anterior pituitary function, and in particular hypotalamic-pituitary-gonadal (HPG) axis and GH-IGF-I axis, in adult patients with treated celiac disease. For this purpouse, 22 celiac patients (15 M, 7 F, mean age: 34 years, range: 1974 years) were studied by GHRH+arginine test. In male patients (mean age: 30 years, range: 1947 years), GnRH test was also performed. All patients were evaluated for serum IGF-I, testosterone (M), basal thyroid and adrenal function and antithyroid antibodies. In 20 out of 22 patients, antipituitary antibodies (APA) were also evaluated.
No alterations in basal TSH, FT4, FT3, ACTH, cortisol, LH, FSH and testosterone levels were detected. Three patients (2 F, 1M) resulted positive for antithyroid antibodies. A normal response to GnRH test was detected in all cases. Four out of 22 patients (18.8%) showed an impaired GH secretion after GHRH+arginine test; in particular, four male patients (4/15, 26.7%) showed a GH deficiency (GHD)(1 patient with complete GHD and 3 with partial GHD), while in none female patients an impaired GH response was recorded. IGF-I levels where low in the patient with complete GHD. All patients, including these with complete or partial GHD, resulted negative for APA. No correlation between GHD deficiency and onset of disease was found.
In conclusion, adult celiac patients show an impaired GH secretion in a significant proportion of cases, this alteration seeming to be predominant in males and independent from disease onset. Given the absence of APA, the cause of this pituitary dysfunction is still unclear and requires further elucidations.
28 Apr - 02 May 2007
European Society of Endocrinology