Growth in Crohn's disease.

Area of Science:

• Pediatric Gastroenterology
• Endocrinology
• Growth Disorders

Background:

• Abnormal linear growth, including growth retardation and delayed puberty, is common in pediatric Crohn's disease.
• Over 50% of patients exhibit subnormal height velocity, with approximately 25% developing short stature.
• Endocrine status shows normal growth hormone but slightly low insulin-like growth factor I, linked to nutritional status.

Purpose of the Study:

• To outline the typical growth patterns in children and adolescents with Crohn's disease.
• To discuss the endocrine factors influencing growth in these patients.
• To review therapeutic strategies for improving growth outcomes.

Main Methods:

• Review of growth patterns, skeletal maturation, and pubertal development in pediatric Crohn's disease.
• Analysis of endocrine status, including growth hormone and insulin-like growth factor I levels.
• Evaluation of therapeutic interventions such as intestinal resection and enteral nutrition.

Main Results:

• Growth retardation and delayed puberty are characteristic of Crohn's disease in children.
• Nutritional status significantly influences growth parameters, with implications for insulin-like growth factor I levels.
• Intestinal resection for localized disease and enteral nutrition for widespread disease yield excellent growth responses.

Conclusions:

• Optimal management of growth issues in pediatric Crohn's disease requires a multidisciplinary approach.
• Close collaboration between gastroenterologists and endocrinologists is crucial.
• Auxological monitoring is essential for documenting therapeutic efficacy and guiding patient management.