Abstract
Growth retardation is a common complication of pediatric inflammatory bowel disease (IBD), which may have long term effects on final adult height and carries significant social and psychological implications. Etiology may be multifactorial including undernutrition, metabolic dysregulation, inflammatory impact on hormonal growth axis and the effect of drugs such as glucocorticoids. Control of disease activity and minimizing the need for corticosteroid therapy are necessary measures in order to facilitate normal growth. However, in many cases these strategies are not sufficient. Currently, there is inconsistent evidence regarding the efficacy of available therapeutic agents to induce long-term effect on growth. The new era of biologic therapies which carries a greater potential to achieve mucosal healing, holds promise for better growth even in children with severe growth impairment. It becomes apparent that prompt recognition of growth impairment combined with aggressive tailored therapeutic approach may offer the best chance for catch-up growth. This review will discuss the definition, prevalence and mechanism of growth retardation in children with IBD and highlight the specific benefits of current therapeutic strategies.
Highlights
25% of patients with inflammatory bowel disease (IBD) are diagnosed during childhood or adolescence
Children with IBD who present with significant growth retardation during the course of their disease pose a particular challenge for the treating physician
Current data do suggest that a proportion of children with IBD will not achieve their expected final height
Summary
25% of patients with inflammatory bowel disease (IBD) are diagnosed during childhood or adolescence. Growth impairment is commonly seen in children diagnosed with IBD, mainly those with Crohn's disease (CD). Growth failure may be present years before diagnosis of IBD, and it commonly persists despite disease specific treatments with implications on final adult height. Definition and prevalence Linear growth failure in children is defined as height below the 3rd percentile or height z-score of below a standard deviation score (SDS) of -2. Another suggested definition is a decrease in height SDS since diagnosis of ≥ 0.75 [1], the formal definitions preclude children with subnormal growth velocity who experience decline in their growth within the defined limits. Lee et al [21] reported that 88% of pediatric CD patients suffered from growth impairment at diagnosis compared to 12% of pediatric UC
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
