Growth Hormone Deficiency Associated with Celiac Disease Revealed by Persistent Growth Failure Despite a Gluten Free Diet: A Retrospective Case Series

Abstract

Introduction: Celiac disease (CD) is an autoimmune enteropathy frequently associated with growth failure. A gluten-free diet (GFD) usually allows catch-up growth. Lack of response suggests an associated condition, particularly growth hormone (GH) deficiency.

Objective: To describe the clinical, biological, and outcome characteristics of patients with CD associated with GH deficiency.

Methods: This retrospective study included patients with confirmed CD and GH deficiency documented by dynamic testing, with failure of catch-up growth after at least 12 months of strict GFD.

Results: Seven patients (6 males, 1 female), with a mean age of 14 years (range 7–19 years), were included. Severe growth failure (< −3 SDS) was present in 71% of cases. No catch-up growth occurred despite adherence to a strict GFD. GH deficiency was partial in 6 cases and complete in 1 case. Pituitary MRI was normal in all patients, consistent with idiopathic GH deficiency. GH therapy resulted in a mean height gain of +1.5 SDS.

Conclusion: GH deficiency should be investigated in patients with persistent growth failure despite a gluten-free diet.

Citation

Gorgi K, Chaouche M. Growth Hormone Deficiency Associated with Celiac Disease Revealed by Persistent Growth Failure Despite a Gluten-Free Diet: A Retrospective Case Series. WebLog J Endocrinol Diabetes. wjed.2026.g1102. https://doi.org/10.5281/zenodo.21459004