Growth retardation in pediatric Crohn's disease: pathogenesis and interventions.
Growth retardation (GR) may pose a significant challenge to the quality of life and the proper management of children and adolescents with Crohn's disease (CD). It can occur in a significant proportion of patients, and may precede clinical evidence of bowel disease. Current evidence suggests that GR is a complex interaction between nutritional status, inflammation, disease severity, and genotype, which causes resistance to the effects of growth hormone. Recent research has identified a key role for the inflammatory cytokines TNF alpha, IL-6, and IL1 beta. This review summarizes current knowledge as well as gaps in our understanding of the mechanisms involved and the usefulness of the different treatment modalities in promoting growth in CD patients.
Shamir
Raanan
R
Pediatric Gastroenterology Division of the Meyer Children's Hospital, Haifa.
Phillip
Moshe
M
Levine
Arie
A
D000293:Adolescent; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D002648:Child; D015362:Child Nutrition Disorders / Q000209:etiology; D003424:Crohn Disease / Q000150:complications*; D004750:Enteral Nutrition; D006130:Growth Disorders / Q000209:etiology* / Q000628:therapy; D019382:Human Growth Hormone / Q000627:therapeutic use; D006801:Humans; D000069285:Infliximab
D000911:Antibodies, Monoclonal; D019382:Human Growth Hormone; D000069285:Infliximab