Dear Dr Butt,

Regarding your article, 'GPs need to be able to recognise symptoms of coeliac disease', which appeared in the January 2007 issue of Guidelines in Practice, I was extremely disappointed that short stature (particularly in children) was not listed as a sign/symptom of coeliac disease in Box 3. In 'Key points for GPs' you state that the condition is easily missed—and that is because GPs in general do not take growth into account.

Yours sincerely,

Tam Fry
Honorary Chairman
Child Growth Foundation


Dear Mr Fry,

Thank you for your comments. The article that I authored for the January issue of Guidelines in Practice was based on adult coeliac disease guidelines, however, I would agree that short stature and impaired growth are an important presentation of childhood coeliac disease. Furthermore, I agree that assessment of a child's growth is an important part of primary care assessment of suspected childhood illness.

Yours sincerely,

Dr Sohail Butt

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