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Early-onset Crohn's disease is a risk factor for smaller final height
Denise Herzog1, Nicolas Fournier, Patrick Buehr
1aDepartment of Pediatrics, Division of Gastroenterology, Cantons Hospital of Fribourg, Fribourg bUniversity Hospital of Lausanne, Institute of Social and Preventive Medicine cDivision of Gastroenterology, University Children's Hospital of Lausanne, Lausanne dDivision of Gastroenterology and Nutrition eChildren's Research Center, University Children's Hospital Zurich, Zurich fDivision of Gastroenterology, Children's Hospital of Lucerne, Lucerne gDivision of Gastroenterology, University Children's Hospital of Bern, Bern, Switzerland.
Objectives:
Growth retardation is a frequent complication of paediatric inflammatory bowel disease (IBD). Only a few studies report the final height of these patients, with controversial results. We compared adult height of patients with paediatric IBD with that of patients with adult-onset disease.
Methods:
Height data of 675 women 19-44 years of age and 454 men 23-44 years of age obtained at inclusion in the Swiss IBD cohort study registry were grouped according to the age at diagnosis: (a) prepubertal (men≤13, women≤11 years), (b) pubertal (men 13-22, women 11-18 years) and (c) adult (men>22, women>18 years of age), and compared with each other and with healthy controls.
Results:
Male patients with prepubertal onset of Crohn's disease (CD) had significantly lower final height (mean 172±6 cm, range 161-182) compared with men with pubertal (179±6 cm, 161-192) or adult (178±7 cm, 162-200) age at onset and the general population (178±7 cm, 142-204). Height z-scores standardized against heights of the normal population were significantly lower in all patients with a prepubertal diagnosis of CD (-0.8±0.9) compared with the other patient groups (-0.1±0.8, P<0.001). Prepubertal onset of CD emerged as a risk factor for reduced final height in patients with prepubertal CD. No difference for final height was found between patients with ulcerative or unclassified IBD diagnosed at prepubertal, pubertal or adult age.
Conclusion:
Prepubertal onset of CD is a risk for lower final height, independent of the initial disease location and the necessity for surgical interventions.
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