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Growth in paediatric Crohn's disease.

J P Cezard1, G Touati, C Alberti

  • 1The French Group of Paediatric Gastroenterology and Nutrition, Hôpital Robert Debré, Paris, France. jean-pierre.cezard@rdb-ap-hop-paris.fr

Hormone Research
|October 10, 2002
PubMed
Summary

Growth failure in pediatric Crohn's disease (CD) affects over 20% of patients, impacting bone and sexual development. New therapeutic strategies are needed to address this persistent complication in children with CD.

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Area of Science:

  • Pediatric Gastroenterology
  • Inflammatory Bowel Disease Research
  • Pediatric Endocrinology

Background:

  • Growth failure (GF) is a significant complication in pediatric inflammatory bowel disease (IBD), particularly Crohn's disease (CD), affecting linear growth, bone development, and sexual maturation.
  • While temporary GF occurs in 40-50% of pediatric CD cases, prolonged GF impacts 10-20%, and is rare in ulcerative colitis (5%).
  • Causes of GF include poor nutritional intake, increased energy expenditure due to inflammation, intestinal losses, hypopituitarism, and corticosteroid treatment.

Purpose of the Study:

  • To evaluate the prevalence and persistence of growth failure in children with Crohn's disease over a 2-year follow-up period.
  • To identify factors associated with growth failure in pediatric CD patients.
  • To inform the development of future therapeutic strategies for managing growth failure in pediatric CD.

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Main Methods:

  • A prospective, multicenter study followed 82 children with Crohn's disease for 2 years.
  • Growth parameters (specifically, Z-scores for height) were monitored throughout the study period.
  • Data on steroid use, enteral nutrition, and disease severity were collected and analyzed in relation to growth outcomes.

Main Results:

  • Initially, 15% of patients had severe growth failure (<-2 SD), with 11 of these remaining below -2 SD after 2 years.
  • An additional 6% of patients developed growth failure during the follow-up, resulting in 21% of the cohort exhibiting growth failure at 2 years.
  • No significant differences in initial growth velocity, steroid use, enteral nutrition, or disease severity were observed between patients with and without growth failure.

Conclusions:

  • A significant proportion of children with Crohn's disease experience persistent growth failure, even with current therapeutic approaches.
  • The study highlights the need for novel treatment strategies to effectively manage growth failure as a complication of pediatric CD.
  • Further research is warranted to understand the underlying mechanisms and develop targeted interventions for improving growth outcomes in these patients.