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Growth failure in children and adolescents with Crohn's disease

Katja Tietjen1, Rolf Behrens, Edda Weimann

  • 1Kinder- und Jugendklinik der Friedrich-Alexander-Universität Erlangen Klinik für Kinderheilkunde und Jugendmedizin am Sankt Bernward Krankenhaus Hildesheim, Nürnberg, Germany. katja.tietjen@web.de

The Turkish Journal of Gastroenterology : the Official Journal of Turkish Society of Gastroenterology
|March 31, 2009
PubMed

Insights

Growth failure in Crohn's disease is not due to growth hormone deficiency. High disease activity, not corticosteroid therapy, significantly impacts impaired growth in pediatric Crohn's disease patients.

Area of Science:

  • Pediatric Endocrinology
  • Gastroenterology
  • Growth Disorders

Background:

  • Crohn's disease (CD) is a chronic inflammatory condition affecting the gastrointestinal tract.
  • Growth failure is a significant concern in children and adolescents diagnosed with CD.
  • The etiology of growth failure in pediatric CD patients remains incompletely understood.

Purpose of the Study:

  • To investigate the role of impaired growth hormone (GH) secretion in growth failure among pediatric, adolescent, and young adult patients with Crohn's disease.
  • To determine if GH deficiency contributes to growth impairment in this population.
  • To assess the impact of corticosteroid therapy and disease activity on growth.

Main Methods:

  • A cohort of 40 patients (26 male, 14 female; age range 4-29 years) with Crohn's disease was analyzed.
  • Urinary growth hormone excretion was measured using an immunoradiometric assay in morning urine samples.
  • Parameters assessed included renal function, chronological age, height, growth rate, pubertal stage, disease localization, Pediatric Crohn Disease Activity Index (PCDAI), corticosteroid use, and IGF-1 levels.

Main Results:

  • Normal urinary growth hormone levels were observed in patients with Crohn's disease, suggesting that growth hormone deficiency is not the primary cause of growth failure.
  • Corticosteroid therapy did not emerge as the most significant factor contributing to growth failure.
  • High disease activity, as indicated by a high PCDAI score, was found to have a substantial impact on impaired growth.

Conclusions:

  • Growth failure in children and adolescents with Crohn's disease is not attributable to impaired growth hormone secretion.
  • Elevated disease activity, reflected by a high PCDAI, is a key determinant of impaired growth in pediatric CD patients.
  • Further research should focus on managing inflammation to improve growth outcomes in this population.
Abstract

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