Related Experiment Video
Updated: May 20, 2026
Visualization of Estrogen Receptors in Colons of Mice with TNBS-Induced Crohn's Disease using Immunofluorescence
Published on: March 12, 2020
Menarche in pediatric patients with Crohn's disease
Neera Gupta1, Robert H Lustig, Michael A Kohn
1Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California, San Francisco, 500 Parnassus Avenue, MU-407 East, Box 0136, San Francisco, CA 94143, USA. ng719@yahoo.com
Insights
Age at menarche is delayed in girls with Crohn's disease (CD) compared to controls. Bone age at menarche is similar, but chronological age differs by race, suggesting potential endocrine evaluation if delayed.
Area of Science:
- Pediatric Endocrinology
- Gastroenterology
- Reproductive Health
Background:
- The timing of menarche in pediatric Crohn's disease (CD) is not well-documented.
- Understanding menarche onset in CD is crucial for monitoring growth and development.
Purpose of the Study:
- To investigate the age of menarche onset in pediatric patients with Crohn's disease.
- To identify factors associated with menarche timing in CD patients.
Main Methods:
- Comparison of menarche age between 34 CD patients and 545 controls using NHANES data.
- Analysis of chronological age (CA) and bone age (BA) at menarche.
- Assessment of menarche timing across different racial groups.
Main Results:
- Median CA at menarche was significantly delayed in CD patients (13.9 years) compared to controls (12.0 years).
- Menarche occurred by bone age 13.5 years in 68% of CD patients and by BA >14.0 years in 100%.
- Menarche onset varied by race, being earliest in South Asians, followed by East Asians, and then Caucasians.
Conclusions:
- Chronological age at menarche is delayed in Crohn's disease patients.
- Bone age at menarche in CD patients is comparable to healthy children.
- Delayed menarche (after BA >14.0 years) in CD warrants consideration for endocrinology referral.
Background And Aims:
The timing of menarche in Crohn's disease (CD) is poorly described. Our objectives were to study age at menarche onset in CD, and factors associated with this.
Methods:
We compared the age at menarche of 34 CD patients with that for 545 controls, using data in the National Health and Nutrition Examination Survey (NHANES).
Results:
Mean chronological age (CA) of CD patients (15.6 years) did not differ from that of the NHANES cohort (15.7 years; P = 0.91). The median CA at menarche (13.9 years) in CD was older than in the NHANES sample (12.0 years) (P < 0.00005). In CD patients, the cumulative incidence of menarche was 10 % at CA 12 years, 51 % at CA 14 years, and 100 % at CA 16 years. Sixty-eight percent reached menarche by bone age (BA) 13.5 years and 100 % by BA greater than 14.0 years. Menarche occurred earliest in South Asians, followed by East Asians, and then Caucasians (P = 0.02).
Conclusions:
CA at menarche is delayed in CD compared with the NHANES cohort. BA at menarche in CD is similar to BA at menarche reported for healthy children. CA at menarche in CD differs by race. If menarche has not occurred by BA greater than 14.0 years, endocrinology referral should be considered.
Related Concept Videos
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
01:25Inflammatory Bowel Disease III: Crohn's Disease
01:20Inflammatory Bowel Disease IV: Clinical Manifestations
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the colonic...
01:26Inflammatory Bowel Disease I: Introduction
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...