Seroprevalence of Celiac Disease Among Childrenwith Short Stature in Sana’a City, Yemen

Background: Celiac disease (CD) is an immune-mediated enteropathy in individuals genetically susceptible to gluten and its related proteins. It is an important but often under-recognized cause of short stature in children, frequently presenting without gastrointestinal symptoms. This study aimed to determine the seroprevalence of CD among children with short stature in Sana’a City, Yemen.
Methods: A retrospective cross-sectional study was conducted at the main Pediatric Endocrinology Center in Sana’a, from August to November 2024. Medical records of 385 children with short stature aged <20 years were reviewed. Data on demographic, clinical, and laboratory characteristics were extracted, and anti-tissue transglutaminase immunoglobulin A (anti-tTG IgA) was used to determine the prevalence of CD. Data were described using frequency and percentage.
Results: The mean age of children was 9.8 ± 4.4 years, with males comprising 58.7%. More than half of the children (51.4%) were older than 10 years. Gastrointestinal manifestations were uncommon, with only three children (0.8%) presenting with diarrhea. Seropositivity for anti-tTG IgA was found in 6% of the tested children, while growth hormone deficiency and low IGF-1 levels were detected in 27% and 41% of the cases, respectively. More than half of the children (51.6%) had a vitamin D deficiency. Concurrent chronic diseases were identified in 17.9% of children, most commonly type 1 diabetes mellitus (6.2%), while Turner syndrome was the most frequent associated genetic disorder (1.8%).
Conclusion: CD is relatively common among children with short stature in Yemen, even in the absence of gastrointestinal symptoms. Growth failure in children with short stature is likely to result from a combination of endocrine, nutritional, and immunological factors. Routine screening for CD should be incorporated into the diagnostic evaluation of all children with an unexplained short stature.