Background: The nonclassic presentation of pediatric celiac disease (CD) becomes increasingly common in daily practice, which requires an awareness of its extraintestinal clinical findings. To evaluate eye involvement and effect of gluten free diet on ocular involvement in pediatric CD patients by measuring the thicknesses of choroid and ganglion cell complex(GCC) composed of retinal nerve fiber layer (RNFL), ganglion cell layer (GCL) and inner plexiform layer (IPL) using enhanced depth imaging optical coherence tomography (EDI-OCT). Methods: Forty-three CD patients aged between four and 16 years (mean age;9.9 ± 4.1, 12 boys and 31 girls), and 48 healthy children (mean age; 11.3 ± 4.1,17 boys and 31 girls) were compared. Following comprehensive eye examinations, thicknesses of choroid at three points and GCC layers (RNFL at five points, GCL and IPL) were obtained using EDI-OCT. Measurement of thicknesses of choroid and GCC layers by a trained EDI-OCT technician and an ophthalmologist who were not aware about group of children in pediatric CD patients with one year gluten free diet. Results: All layers of subfoveal, nasal, temporal choroid were significantly thinner in CD than in the control group (p < .001, p < .001, and p < .001, respectively). No significant difference were observed between the CD and control groups in terms of GCC thicknesses (p > .05). Conclusion: Pediatric CD causing thinning of subfoveal, nasal and temporal areas of choroid, and this change is apparent even after one year gluten free diet. This extraintestinal involvement should be more closely screened at diagnosis and long term clinical results of thin choroid should be determined. Thicknesses of GCC layers were not different in CD group may be revealing the effect of diet or not involvement.

Background: Growth hormone (GH) release is pulsatile, and daytime GH levels are low. GH stimulation tests are therefore needed in cases requiring GH level investigation. The purpose of this study was to compare the results of L-dopa and clonidine GH stimulation tests applied in children with short stature and to identify which of these tests should be primarily selected. Methods: The records of 68 patients aged between 2.5 and 16.6 years presenting to the pediatric endocrinology clinic with short stature and undergoing GH stimulation tests between September 2016 and February 2021 were evaluated retrospectively. Cases with GH levels <10 ng/dl following the first GH stimulation test then underwent the other GH stimulation test. Thirty-four (50%) of the cases in the study consisted of individuals beginning with the clonidine test, while the other 34 (50%) started with the L-dopa test. Results: Seventeen (50%) individuals in whom clonidine was employed in the first test had low GH responses, while a low GH response was determined at the second, L-dopa test, in 15 (88.2%) of these individuals, significant variation being observed between the groups (p< 0.001). Conclusion: GH stimulation tests performed to investigate GHD are laborious and time-consuming. The first stimulation test to be applied to differentiate GHD from ISS must therefore be well selected. The clonidine stimulation test, with higher sensitivity than but similar specificity to the L-dopa test, can be employed as the first test.