Pediatric Inflammatory Bowel Disease
Perspective and ConsequencesEditor(s): Walker-Smith J.A. (London)
Lebenthal E. (Jerusalem)
Branski D. (Jerusalem)
Growth and Puberty in Inflammatory Bowel DiseaseSavage M.O. · Beattie R.M. · Sanderson I.R.S.
Departments of Paediatric Endocrinology and Gastroenterology, Barts and the London School of Medicine and Dentistry, London, and Department of Paediatrics, Southampton General Hospital, Southampton, UK
Professor M. O. Savage, Department of Endocrinology, John Vane Science Centre, Charterhouse Square, London EC1M 6BQ (UK), Tel. +44 20 7882 6233, Fax +44 20 7882 6234, E-Mail email@example.com
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Growth failure and delayed puberty are important features of many patients with inflammatory bowel disease, particularly those with Crohn’s disease. In Crohn’s disease growth may be abnormal before diagnosis and height is inversely proportional to the length of delay in diagnosis. Height is particularly abnormal in patients with jejunal disease. During the course of the illness growth rate is often low, although only 25% of patients develop short stature. Final adult height is decreased, but shows improvement compared with height at diagnosis. The inflammatory process appears to contribute to abnormal growth, through cytokine-induced disturbance of the IGF system. This can be corrected by regimens of enteral nutrition. Genetic factors may influence height as shown by the effect of a polymorphism of the IL-6 gene which was linked to shortness at diagnosis. Therapy for growth failure should aim to induce remission in the primary disease. In prepubertal patients with localized colonic disease intestinal resection has been followed by excellent catch-up growth. Delayed puberty is common and may be treated in boys by short-term testosterone replacement which can induce catch-up growth and improve confidence significantly.
© 2009 S. Karger AG, Basel
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